Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 036096611 | IL |
NPI | 1053391094 |
---|---|
Provider Name | Dr. Asya Segalene |
First Address | Naperville, IL 60563-8609 |
Second Address | Naperville, IL 60563-8609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 21/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0360966114 | (05) | IL |
H10826 | (02) | IL |