Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | IL |
NPI | 1003912247 |
---|---|
Provider Name | Dr. Sandor Hillel Gallai |
First Address | Chicago, IL 60659-3518 |
Second Address | Chicago, IL 60659-3518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 08/07/2007 |