Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 036.145724 | IL |
N | 204F00000X | Transplant Surgeon | 3306900 | ZZ |
NPI | 1710211503 |
---|---|
Provider Name | Daniel Borja Cacho |
First Address | Chicago, IL 60611-2986 |
Second Address | Chicago, IL 60611-2986 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2009 |
Last Update Date | 18/04/2018 |