Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 036.142619 | IL |
NPI | 1467740217 |
---|---|
Provider Name | David Sarcu |
First Address | Aurora, IL 60506 |
Second Address | Aurora, IL 60506-1404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2011 |
Last Update Date | 18/11/2021 |