Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | IL |
NPI | 1457434235 |
---|---|
Provider Name | Javeed Akhter |
First Address | Crest Hill, IL 60403-0864 |
Second Address | Crest Hill, IL 60403-0864 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D15013 | (02) | IL |