Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 125061785 | IL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 036137045 | IL |
NPI | 1467715938 |
---|---|
Provider Name | Lopa K Pandya |
First Address | Chicago, IL 60612-4325 |
Second Address | Chicago, IL 60612-4795 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2012 |
Last Update Date | 08/07/2019 |