Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 070003099 | IL |
NPI | 1003236951 |
---|---|
Provider Name | Christel Comerouski |
First Address | Lombard, IL 60148-6405 |
Second Address | Lombard, IL 60148-6405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2014 |
Last Update Date | 18/04/2014 |