Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038012339 | IL |
NPI | 1003153362 |
---|---|
Provider Name | Dr. Mahmoud S Lotfi |
First Address | Chicago, IL 60655-2205 |
Second Address | Chicago, IL 60655-2205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2013 |
Last Update Date | 29/10/2013 |