Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 2005001335 | MO |
Y | 207K00000X | Allergist & Immunologist | 36117560 | IL |
N | 207RA0201X | Internist - Allergy & Immunology | 2005001335 | MO |
N | 207RA0201X | Internist - Allergy & Immunology | 36117560 | IL |
NPI | 1346335783 |
---|---|
Provider Name | Dr. Patrick Htain Win |
First Address | Shiloh, IL 62269-2993 |
Second Address | Shiloh, IL 62269-2993 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 26/07/2011 |