Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 036048638 | IL |
N | 2080P0201X | Pediatric Allergist | 036048638 | IL |
NPI | 1316927759 |
---|---|
Provider Name | Dr. Sana A Attar |
First Address | Libertyville, IL 60048 |
Second Address | Libertyville, IL 60048-2550 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 03/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036048638 | (05) | IL |