Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 135001066 | IL |
NPI | 1013562578 |
---|---|
Provider Name | Dr. Bishoy Atef Botros |
First Address | Chicago, IL 60657-4744 |
Second Address | Chicago, IL 60612-3728 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2019 |
Last Update Date | 01/08/2019 |