Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036.129256 | IL |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 036.129256 | IL |
NPI | 1033448147 |
---|---|
Provider Name | Dr. Mark Applebaum |
First Address | Chicago, IL 60637-1428 |
Second Address | Chicago, IL 60637-1428 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2009 |
Last Update Date | 08/07/2015 |