Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 036-124500 | IL |
NPI | 1306068200 |
---|---|
Provider Name | Janaki Natarajan |
First Address | Aurora, IL 60506-6222 |
Second Address | Aurora, IL 60506-1404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 22/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036124500 | (05) | IL |
036-124500 | IL MEDICAL LICENSE (01) | IL |
1306068200 | (05) | IA |
24284 | NE MEDICAL LICENSE (01) | NE |
47037660425 | (05) | NE |
T01097 | TEMP MEDICAL LICENSE (01) | KS |