Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 096.003857 | IL |
NPI | 1376007757 |
---|---|
Provider Name | Jose Angel Munoz JR. |
First Address | Aurora, IL 60506-1404 |
Second Address | Chicago, IL 60639-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2019 |
Last Update Date | 30/01/2019 |