Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 036134638 | IL |
NPI | 1043479512 |
---|---|
Provider Name | Dr. Raymond Joseph Metz JR. |
First Address | Elk Grove Village, IL 60007-3306 |
Second Address | Elk Grove Village, IL 60007-3306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2008 |
Last Update Date | 07/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036134638 | (05) | IL |
F400152874 | (02) | IL |