Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | IL |
NPI | 1013907393 |
---|---|
Provider Name | Dr. William A Fitzmaurice JR. |
First Address | Elmhurst, IL 60126-5068 |
Second Address | Elmhurst, IL 60126-5068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 07/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D16467 | (02) | IL |