Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 036-044582 | IL |
N | 207ND0900X | Dermatopathologist | 036-044582 | IL |
NPI | 1770578114 |
---|---|
Provider Name | Dr. Ana M Eng |
First Address | Elmhurst, IL 60126-2923 |
Second Address | Elmhurst, IL 60126-2923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 31/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D10991 | (02) | IL |