Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 036.098074 | IL |
NPI | 1003178518 |
---|---|
Provider Name | Dr. James Michael Torres |
First Address | Inverness, IL 60067-4409 |
Second Address | Inverness, IL 60067-4409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 11/06/2012 |