Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | A104067 | CA |
Y | 208000000X | Pediatrician | 036128594 | IL |
N | 208000000X | Pediatrician | 47798 | MN |
NPI | 1548233638 |
---|---|
Provider Name | Julian H Tang |
First Address | Naperville, IL 60563-9789 |
Second Address | Naperville, IL 60563-9789 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 05/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036128594 | (05) | IL |
D16194 | (02) | IL |