Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 036-110634 | IL |
NPI | 1013993005 |
---|---|
Provider Name | Daniel D Vukas |
First Address | Chicago, IL 60631-3745 |
Second Address | Chicago, IL 60631-3745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 02/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036-110634 | (05) | IL |
I33875 | (02) | IL |