Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 016-003278 | IL |
Y | 222Z00000X | Podiatrist | 016-003278 | IL |
N | 213ES0131X | Foot Surgery | 016-003278 | IL |
NPI | 1124067624 |
---|---|
Provider Name | Dr. David R Doyle |
First Address | La Grange, IL 60525-6136 |
Second Address | La Grange, IL 60525-6136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 29/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T88648 | (02) | IL |