Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 036-041170 | IL |
NPI | 1023129145 |
---|---|
Provider Name | Leonard David Elkun |
First Address | Chicago, IL 60610-6945 |
Second Address | Chicago, IL 60610-6945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 24/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0021604911 | (02) |