Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 036-128987 | IL |
N | 207RA0201X | Internist - Allergy & Immunology | 35088749 | OH |
NPI | 1922219211 |
---|---|
Provider Name | Christopher David Codispoti |
First Address | Chicago, IL 60612-3848 |
Second Address | Chicago, IL 60612-3848 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 01/07/2021 |