Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | IL | |
Y | 213EG0000X | General Practice | IL |
NPI | 1003899790 |
---|---|
Provider Name | Dr. Nicholas Robert Tokarski |
First Address | Maywood, IL 60153-1824 |
Second Address | Maywood, IL 60153-1824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 08/07/2007 |