Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 036127808 | IL |
N | 207KA0200X | Allergist | 036127808 | IL |
N | 207R00000X | Internist | FP2667307 | IL |
N | 111NI0900X | Internist | FP2667307 | IL |
N | 208000000X | Pediatrician | FP2667307 | IL |
N | 2080P0201X | Pediatric Allergist | 036127808 | IL |
NPI | 1609065895 |
---|---|
Provider Name | Andrea Arlene Pappalardo |
First Address | Bloomingdale, IL 60108-2169 |
Second Address | Bloomingdale, IL 60108-2169 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 07/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036127808 | (05) | IL |