Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 036148719 | IL |
NPI | 1043692726 |
---|---|
Provider Name | Dr. Julia V Katsnelson |
First Address | Lincolnshire, IL 60069-2931 |
Second Address | Lincolnshire, IL 60069-2906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2015 |
Last Update Date | 17/09/2021 |