Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 038013354 | IL |
NPI | 1205496502 |
---|---|
Provider Name | Nicholas Schmidlkofer |
First Address | Wood Dale, IL 60191-1978 |
Second Address | Wood Dale, IL 60191-1978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2019 |
Last Update Date | 18/06/2019 |