Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 036087241 | IL |
NPI | 1003085564 |
---|---|
Provider Name | Dr. Raymond S Belmonte |
First Address | Niles, IL 60714-2828 |
Second Address | Chicago, IL 60602-1708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2008 |
Last Update Date | 02/05/2008 |