Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | IL | |
N | 207XS0106X | Orthopaedic Hand Surgeon | IL |
NPI | 1154446235 |
---|---|
Provider Name | Dr. Surrenthia R Parker |
First Address | Chicago, IL 60649-3954 |
Second Address | Chicago, IL 60649-3954 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F59427 | (02) | IL |