Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 036152233 | IL |
NPI | 1295197754 |
---|---|
Provider Name | Dr. Julio Cordero |
First Address | Evanston, IL 60201 |
Second Address | Evanston, IL 60201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2016 |
Last Update Date | 20/04/2020 |