Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 036114409 | IL |
NPI | 1003015892 |
---|---|
Provider Name | Dr. Thiruppathy R. Sabapathy |
First Address | Naperville, IL 60563-8450 |
Second Address | Naperville, IL 60540-7430 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 10/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036-114409 | ILLINOIS STATE LICENSE (01) | IL |