Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | IL | |
N | 207RA0201X | Internist - Allergy & Immunology | IL |
NPI | 1588708770 |
---|---|
Provider Name | Julie C Klemens |
First Address | Lombard, IL 60148-2670 |
Second Address | Lombard, IL 60148-2670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I48534 | (02) | IL |