Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 038-007191 | IL |
NPI | 1144309436 |
---|---|
Provider Name | Dr. Jinhwa Lee Suh |
First Address | Hoffman Estates, IL 60195-3714 |
Second Address | Hoffman Estates, IL 60195-3714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U38531 | (02) | IL |