Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 036045354 | IL |
NPI | 1013918804 |
---|---|
Provider Name | Muhammad As Saudye |
First Address | Chicago, IL 60640-5719 |
Second Address | Chicago, IL 60640-5719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 16/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C39659 | (02) | IL |