Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 036134376 | IL |
N | 2084N0400X | Neurologist | 125-058858 | IL |
Y | 2084N0600X | Clinical Neurophysiologist | 036134376 | IL |
NPI | 1619288701 |
---|---|
Provider Name | Dr. Mineshkumar Morker |
First Address | Geneva, IL 60134-4209 |
Second Address | Dekalb, IL 60115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 26/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036134376 | (05) | IL |
206147 | MEDICARE PTAN GROUP (01) | IL |
F400277359 | MEDICARE PTAN INDIVIDUAL (01) | IL |