Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 036121668 | IL |
NPI | 1033183728 |
---|---|
Provider Name | Dr. David G Cable |
First Address | Rockford, IL 61108-2464 |
Second Address | Rockford, IL 61108-2490 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2006 |
Last Update Date | 06/10/2015 |