Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 036-082895 | IL |
Y | 208600000X | Surgeon | 036-082895 | IL |
N | 208C00000X | Colorectal Surgeon | 036-082895 | IL |
NPI | 1013950690 |
---|---|
Provider Name | David P Ondrula |
First Address | Barrington, IL 60010-1860 |
Second Address | Barrington, IL 60010-1860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 04/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BC BS | 04929950 (01) | IL |