Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 125063917 | IL |
NPI | 1093962813 |
---|---|
Provider Name | Hideki Ogiwara |
First Address | Chicago, IL 60610-5149 |
Second Address | Chicago, IL 60614-3363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2008 |
Last Update Date | 22/08/2008 |