Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 036096283 | IL |
NPI | 1043297799 |
---|---|
Provider Name | Dr. Robert D. Paras |
First Address | Aurora, IL 60504-7597 |
Second Address | Aurora, IL 60504-7597 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2005 |
Last Update Date | 20/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036096283 | (05) | IL |
H11545 | (02) | IL |