Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | P1668 | TX |
N | 111NI0900X | Internist | P1668 | TX |
Y | 207RX0202X | Medical Oncology | 036-142503 | IL |
N | 207RX0202X | Medical Oncology | P1668 | TX |
NPI | 1164650859 |
---|---|
Provider Name | Devalingam Mahalingam |
First Address | Chicago, IL 60611-2814 |
Second Address | Chicago, IL 60611-2814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2009 |
Last Update Date | 20/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
206454501 | (05) | TX |