Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | IL |
NPI | 1386639342 |
---|---|
Provider Name | Audrius V Plioplys |
First Address | Westmont, IL 60559-5511 |
Second Address | Chicago, IL 60620-5441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 11/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2232936 | BCBS PROVIDER ID (01) | IL |
E31010 | (02) | IL |