Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 036.145129 | IL |
NPI | 1376980896 |
---|---|
Provider Name | Dr. William Patrick Boyan JR. |
First Address | Chicago, IL 60611-2986 |
Second Address | Chicago, IL 60611-2986 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2013 |
Last Update Date | 30/10/2018 |