Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 016-002981 | IL |
N | 222Z00000X | Podiatrist | 016-002981 | IL |
N | 2081S0010X | Sports Medicine | 016-002981 | IL |
N | 213ES0000X | Sports Medicine | 016-002981 | IL |
Y | 213ES0103X | Foot & Ankle Surgery | 016-002981 | IL |
NPI | 1457353096 |
---|---|
Provider Name | Dr. Michael Rand Hollander |
First Address | Mt Prospect, IL 60056-1141 |
Second Address | Mt Prospect, IL 60056-1141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 15/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T36976 | (02) | IL |