Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | IL |
NPI | 1083627897 |
---|---|
Provider Name | Dr. John Joseph Natale |
First Address | Barrington, IL 60010 |
Second Address | Chicago, IL 60625-3645 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 24/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01636263 | BLUE CROSS BLUE SHIELD (01) | |
A15376 | (02) | |
K47100 | MEDICARE PTAN (01) |