Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 006057919 | IL |
NPI | 1376837146 |
---|---|
Provider Name | Ms. Judy A Solomon |
First Address | Arlington Heights, IL 60004-5937 |
Second Address | Arlington Heights, IL 60004-5937 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2011 |
Last Update Date | 08/06/2011 |