Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 016002721 | IL |
Y | 222Z00000X | Podiatrist | 016002721 | IL |
NPI | 1073520714 |
---|---|
Provider Name | Howard Ira Sterling |
First Address | Wheeling, IL 60090-5315 |
Second Address | Wheeling, IL 60090-5315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 21/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016002721 | (05) | IL |
60000850 | BLUE CROSS BLUE SHIELD (01) | IL |
791480558 | RAILROAD MEDICARE (01) | |
T35524 | (02) |