Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 036058340 | IL |
NPI | 1396716106 |
---|---|
Provider Name | Dr. James David Schlenker |
First Address | Oak Lawn, IL 60453-2201 |
Second Address | Oak Lawn, IL 60453-2201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 22/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C45204 | (02) | IL |
CL1274 | RAILROAD MEDICARE (01) |