Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 036104807 | IL |
NPI | 1063495851 |
---|---|
Provider Name | Dr. Narendra Narepalem |
First Address | Mount Prospect, IL 60056-6036 |
Second Address | Mount Prospect, IL 60056-6036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2005 |
Last Update Date | 31/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036104807 | (05) | IL |
H40568 | (02) | IL |