Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 036107882 | IL |
NPI | 1023167004 |
---|---|
Provider Name | Dr. Daniel Daeyol So |
First Address | Arlington Heights, IL 60005-4185 |
Second Address | Arlington Heights, IL 60005-4185 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 05/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G76910 | (02) | IL |