Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 036112759 | IL |
NPI | 1093794620 |
---|---|
Provider Name | Dr. Amee Majmundar |
First Address | Chicago, IL 60674-2014 |
Second Address | Orland Park, IL 60467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 15/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01635439 | BLUE CROSS/SHIELD PPO (01) | IL |
I40631. | (02) | IL |