Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 036105100 | IL |
N | 208200000X | Surgeon | 036-105100 | IL |
N | 208600000X | Surgeon | 036-105100 | IL |
NPI | 1164587994 |
---|---|
Provider Name | Dr. Marc Rider Garfinkel |
First Address | Springfield, IL 62794-9638 |
Second Address | Springfield, IL 62702-6700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2006 |
Last Update Date | 22/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036105100 | (05) | IL |