Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 036151658 | IL |
N | 2081S0010X | Sports Medicine | 036.151658 | IL |
N | 213ES0000X | Sports Medicine | 036.151658 | IL |
NPI | 1538556774 |
---|---|
Provider Name | Joseph Gregory Dadabo |
First Address | Glenview, IL 60026-1339 |
Second Address | Glenview, IL 60026-1339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2015 |
Last Update Date | 20/07/2020 |