Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 060360179 | IL |
NPI | 1033760715 |
---|---|
Provider Name | Michael James Doolin |
First Address | Chicago, IL 60607-5037 |
Second Address | Chicago, IL 60607-5037 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2019 |
Last Update Date | 24/09/2019 |