Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 036092279 | IL |
NPI | 1447369327 |
---|---|
Provider Name | Dr. Miguel Camara |
First Address | Crest Hill, IL 60403-0928 |
Second Address | Crest Hill, IL 60403-0928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 26/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G26894 | (02) | IL |