Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 036-083328 | IL |
Y | 207PP0204X | Pediatric Emergency Physician | 036-083328 | IL |
NPI | 1235281924 |
---|---|
Provider Name | Dr. George Paul |
First Address | Evanston, IL 60202-1127 |
Second Address | Naperville, IL 60540-7430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 28/04/2021 |