Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | IL |
NPI | 1841230471 |
---|---|
Provider Name | Krishna Anjali Singh |
First Address | Springfield, IL 62794-9639 |
Second Address | Springfield, IL 62701-1041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 18/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H64104 | (02) |