Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 036104701 | IL |
N | 2080P0214X | Pediatric Pulmonologist | 036104701 | IL |
NPI | 1346314564 |
---|---|
Provider Name | Mrs. Nada Aldallal |
First Address | Chicago, IL 60609-3833 |
Second Address | Chicago, IL 60609-3833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 01/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001634293 | BCBS (01) | |
036104701 | (05) | IL |
I46465 | (02) | IL |