Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 036-042821 | IL |
N | 207T00000X | Neurosurgeon | 31594-20 | WI |
N | 207X00000X | Orthopaedic Surgeon | 036-042821 | IL |
Y | 207X00000X | Orthopaedic Surgeon | 31594-20 | WI |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 036-042821 | IL |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 31594-20 | WI |
N | 207XS0106X | Orthopaedic Hand Surgeon | 036-042821 | IL |
N | 207XS0106X | Orthopaedic Hand Surgeon | 036042821 | IL |
N | 207XS0106X | Orthopaedic Hand Surgeon | 31594-20 | WI |
N | 207XS0106X | Orthopaedic Hand Surgeon | 31594020 | WI |
N | 207XS0117X | Orthopaedic Spine Surgeon | 036-042821 | IL |
N | 207XS0117X | Orthopaedic Spine Surgeon | 31594-20 | WI |
NPI | 1831290147 |
---|---|
Provider Name | Dr. Hosein A. Motamed, M.d., M.sc. |
First Address | Chicago, IL 60645-5815 |
Second Address | Chicago, IL 60645-5815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 12/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0021601775 | BLUE SHIELD (01) | IL |
036042821 | (05) | IL |
C41417 | (02) | IL |