Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 036150518 | IL |
NPI | 1245636695 |
---|---|
Provider Name | Hector Lantigua |
First Address | Urbana, IL 61801 |
Second Address | Urbana, IL 61801-2529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2014 |
Last Update Date | 09/02/2022 |