Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 036065505 | IL |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 036065505 | IL |
NPI | 1003802810 |
---|---|
Provider Name | Ernest B. Lindell |
First Address | Chicago, IL 60674-0018 |
Second Address | Naperville, IL 60540-8902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 22/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036065505 | (05) | IL |
200042405 | RAILROAD MEDICARE (01) | IL |
G52658 | (02) |