Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 34004387 | OH |
NPI | 1104163492 |
---|---|
Provider Name | Dr. James Embrescia |
First Address | Evanston, IL 60202-2391 |
Second Address | Evanston, IL 60202-2391 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2013 |
Last Update Date | 07/01/2013 |