Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 036-074020 | IL |
NPI | 1134152739 |
---|---|
Provider Name | David Mael |
First Address | Des Plaines, IL 60016-4539 |
Second Address | Chicago, IL 60657-5188 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 19/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C51121 | (02) | IL |