Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 036087371 | IL |
NPI | 1083719991 |
---|---|
Provider Name | Dr. Iqbal M Akhter |
First Address | Mount Vernon, IL 62864 |
Second Address | Mount Vernon, IL 62864 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 17/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036087371 | (05) | IL |
G11314 | (02) | IL |