Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 036-081988 | IL |
NPI | 1023041522 |
---|---|
Provider Name | James Calvin |
First Address | Chicago, IL 60612-3841 |
Second Address | Chicago, IL 60612-3841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 20/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E74617 | (02) | IL |