Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | D64644 | MD |
N | 111NI0900X | Internist | D64644 | MD |
Y | 207RH0000X | Hematologist | 036-125922 | IL |
NPI | 1134275845 |
---|---|
Provider Name | Dr. Brady Lee Stein |
First Address | Chicago, IL 60611-2814 |
Second Address | Chicago, IL 60611-2814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 16/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014071600 | (05) | MD |