Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 036-093373 | IL |
NPI | 1013919737 |
---|---|
Provider Name | Dr. Daniel Katz |
First Address | Aurora, IL 60504-7205 |
Second Address | Aurora, IL 60504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 13/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036-093373-2 | (05) | IL |
G53858 | (02) | IL |