Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 036118637 | IL |
NPI | 1417159310 |
---|---|
Provider Name | Dr. Qin Li Jiang |
First Address | Chicago, IL 60612-4300 |
Second Address | Chicago, IL 60612-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2007 |
Last Update Date | 18/02/2013 |