Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 21993 | TX |
N | 213EG0000X | General Practice | 21993 | TX |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 021.002733 | IL |
NPI | 1003915075 |
---|---|
Provider Name | Dr. Nadeem S Esmail |
First Address | Peoria, IL 61604-2869 |
Second Address | Peoria, IL 61604-2869 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 23/05/2016 |