Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 36062850 | IL |
NPI | 1548244825 |
---|---|
Provider Name | Dr. Alan H. Resnick |
First Address | Orland Park, IL 60467-8713 |
Second Address | Orland Park, IL 60467-8713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 21/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036062850 | (05) | IL |
D89441 | (02) | IL |