Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | IL |
NPI | 1003800954 |
---|---|
Provider Name | Dr. Maysan Alshaar |
First Address | Chicago, IL 60614-3363 |
Second Address | Chicago, IL 60614-3363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G56948 | (02) | IL |