Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 0011606 | UT |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 036.140875 | IL |
NPI | 1033535018 |
---|---|
Provider Name | Dr. Jota Nakano |
First Address | Chicago, IL 60611 |
Second Address | Chicago, IL 60611-3197 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2014 |
Last Update Date | 15/01/2020 |