Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 036.127038 | IL |
NPI | 1003011966 |
---|---|
Provider Name | Dr. Aaron Daniel Kallsnick |
First Address | Oak Brook, IL 60523-2006 |
Second Address | Chicago, IL 60634-4403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 09/05/2014 |