Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 036133570 | IL |
N | 207T00000X | Neurosurgeon | 45793 | AZ |
NPI | 1083811418 |
---|---|
Provider Name | Dr. Shakeel Ahmad Chowdhry |
First Address | Evanston, IL 60201-1718 |
Second Address | Glenview, IL 60026-1339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 26/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036133570 | STATE LICENSE (01) | IL |