Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 036-085074 | IL |
NPI | 1104079276 |
---|---|
Provider Name | Dr. Rudy John Allen |
First Address | Chicago, IL 60614-3363 |
Second Address | Chicago, IL 60614-3363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2008 |
Last Update Date | 02/11/2008 |