Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038012309 | IL |
NPI | 1003154311 |
---|---|
Provider Name | Hassan Suhail Baqir |
First Address | Downers Grove, IL 60515-1010 |
Second Address | Downers Grove, IL 60515-1010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2013 |
Last Update Date | 08/01/2014 |