Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 036-140724 | IL |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 036140724 | IL |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 65606-20 | WI |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | AN5240394 6069 | IL |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 036140724 | IL |
NPI | 1518114313 |
---|---|
Provider Name | Dr. Patrick E. Simon |
First Address | Chicago, IL 60611 |
Second Address | Winfield, IL 60190 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2008 |
Last Update Date | 23/08/2018 |