Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 036.118998 | IL |
NPI | 1053502005 |
---|---|
Provider Name | Dr. Sapna Patel Vaghani |
First Address | Manitowoc, WI 54220-4630 |
Second Address | Crest Hill, IL 60403-1865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2007 |
Last Update Date | 24/02/2021 |