Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 036108484 | IL |
NPI | 1144310046 |
---|---|
Provider Name | James B. Kase JR. |
First Address | Quincy, IL 62301-2719 |
Second Address | Quincy, IL 62301-2719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036108484 | (05) | IL |
D17588 | (02) |