Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 036.113918 | IL |
NPI | 1376717900 |
---|---|
Provider Name | Dr. Brian Dominic Bordini |
First Address | Skokie, IL 60077-1057 |
Second Address | Skokie, IL 60077-1057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2008 |
Last Update Date | 02/04/2021 |