Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 3641089 | IL |
NPI | 1083616510 |
---|---|
Provider Name | Dr. Jeffrey Louis Karasick |
First Address | Skokie, IL 60076-1259 |
Second Address | Skokie, IL 60076-1259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C41776 | (02) | IL |