Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 16-002796 | IL |
N | 111NR0200X | Radiology | 16-002796 | IL |
N | 213ER0200X | Radiology | 16-002796 | IL |
N | 2081S0010X | Sports Medicine | 16-002796 | IL |
N | 213ES0000X | Sports Medicine | 16-002796 | IL |
N | 213ES0103X | Foot & Ankle Surgery | 16-002796 | IL |
NPI | 1316089378 |
---|---|
Provider Name | Dr. William A. Mohs |
First Address | Hoffman Estates, IL 60192-1573 |
Second Address | Hoffman Estates, IL 60192-1573 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 20/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171289 | MEDICARE NUMBER (01) | IL |
MOH002335 | IPA - ASSOC. FOOT & ANKLE (01) | IL |
T36937 | (02) | IL |