Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | IL |
NPI | 1114957594 |
---|---|
Provider Name | Dr. Raghbir Singh Benawra |
First Address | Park Ridge, IL 60068-1143 |
Second Address | Park Ridge, IL 60068-1143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D83549 | (02) | IL |