Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | IL |
NPI | 1023024452 |
---|---|
Provider Name | Mr. Hany Beshara |
First Address | Naperville, IL 60567-0307 |
Second Address | Naperville, IL 60564-9002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |