Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | IL |
NPI | 1134104193 |
---|---|
Provider Name | Dr. Edward Lawrence Marut |
First Address | Glenview, IL 60026-5823 |
Second Address | Glenview, IL 60026-5823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 04/09/2007 |