Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036.152372 | IL |
Y | 2080P0203X | Pediatric Critical Care Doctor | MT222165 | PA |
NPI | 1043751498 |
---|---|
Provider Name | Dr. Daniel Balcarcel |
First Address | Chicago, IL 60631-1529 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2017 |
Last Update Date | 18/06/2021 |