Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 036103033 | IL |
NPI | 1396731337 |
---|---|
Provider Name | Jane S Oh |
First Address | Arlington Hts, IL 60005-2376 |
Second Address | Arlington Hts, IL 60005-2376 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 09/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036103033 | (05) | IL |
I00863 | (02) | IL |