Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036-078050 | IL |
N | 2084N0400X | Neurologist | 036-078050 | IL |
Y | 2084N0402X | Child Neurologist | 036078050 | IL |
NPI | 1295736726 |
---|---|
Provider Name | Dr. Mohamed Ammar Katerji |
First Address | Naperville, IL 60563 |
Second Address | Naperville, IL 60563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 10/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036078050 | (05) | IL |
036-078050-5 | (05) | IL |
F64773 | (02) |