Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 0101248942 | VA |
N | 208600000X | Surgeon | 0101248942 | VA |
Y | 2086S0120X | Pediatric Surgery | 036137128 | IL |
NPI | 1437310455 |
---|---|
Provider Name | Dr. Manish Tushar Raiji |
First Address | Chicago, IL 60637 |
Second Address | Chicago, IL 60637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2008 |
Last Update Date | 10/05/2017 |