Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | IL |
NPI | 1295756302 |
---|---|
Provider Name | Dr. Marek Piekos |
First Address | Joliet, IL 60435-4912 |
Second Address | Joliet, IL 60435-4912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0600486 | AETNA (01) | IL |
2206563 | BCBS (01) | IL |
7441000 | UHC (01) | IL |
BP3596282 | DEA (01) | IL |
CIGNA | 8889097001 (01) | IL |
G13919 | (02) | IL |