Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | 036- 106665 | IL |
Y | 207RI0200X | Infectious Disease | 036106665 | IL |
N | 207RI0200X | Infectious Disease | L8650 | TX |
N | 207RI0200X | Infectious Disease | MD25513 | ME |
NPI | 1003923426 |
---|---|
Provider Name | Mr. Daniel B Stroupe |
First Address | Oak Park, IL 60304-1091 |
Second Address | Oak Park, IL 60304-1091 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 20/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036106665 | (05) | IL |
1618792 | BCBS (01) | IL |
P00418912 | RAILROAD MEDICARE (01) | IL |