Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 113-000053 | IL |
N | 208200000X | Surgeon | 113-00053 | IL |
N | 208600000X | Surgeon | 113-00053 | IL |
NPI | 1790816916 |
---|---|
Provider Name | Hilary A. Sanfey |
First Address | Springfield, IL 62794-9639 |
Second Address | Springfield, IL 62702-6700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2007 |
Last Update Date | 17/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007305401 | (05) | VA |
F14067 | (02) | VA |