Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 01032593 | IN |
NPI | 1083673552 |
---|---|
Provider Name | James N Dreyfus |
First Address | Homewood, IL 60430-4216 |
Second Address | Munster, IN 46321-4070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 06/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200044440A | (05) | IN |
E05881 | (02) |