Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 036087709 | IL |
NPI | 1093879652 |
---|---|
Provider Name | Dr. William Lowe JR. |
First Address | Chicago, IL 60611-5975 |
Second Address | Chicago, IL 60611-5975 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2006 |
Last Update Date | 19/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B18093 | (02) | IL |