Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 036133992 | IL |
N | 207VX0000X | Obstetrician | 4301089971 | MI |
NPI | 1255520532 |
---|---|
Provider Name | Dr. Neelam Verma |
First Address | Jacksonville, IL 62650-0000 |
Second Address | Jacksonville, IL 62650-0000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 19/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036133992 | (05) | IL |