Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 3640458 | IL |
NPI | 1003828336 |
---|---|
Provider Name | Mr. William P Kearns |
First Address | Prospect Heights, IL 60070-2569 |
Second Address | Prospect Heights, IL 60070-2569 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 28/09/2007 |