Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 038-008697 | IL |
NPI | 1639251663 |
---|---|
Provider Name | Dr. Muhammad Asadullah |
First Address | Darien, IL 60561-4309 |
Second Address | Darien, IL 60561-4309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 17/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
038-008697 | (05) | IL |
547940 | PTAN (01) | IL |
U75725 | (02) | IL |