Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | IL |
NPI | 1083765820 |
---|---|
Provider Name | Dr. Sharad Narandas Salvi |
First Address | Oak Lawn, IL 60453 |
Second Address | Oak Lawn, IL 60453 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01620238 | BC-BS GROUP PROVIDER NUMB (01) | IL |
D14860 | (02) | IL |