Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 125.066071 | IL |
NPI | 1013385293 |
---|---|
Provider Name | Dr. Itay Sagy |
First Address | Chicago, IL 60637-1426 |
Second Address | Chicago, IL 60637-1426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2015 |
Last Update Date | 04/09/2015 |