Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 036-131173 | IL |
NPI | 1003044280 |
---|---|
Provider Name | Nupur Mittal |
First Address | Chicago, IL 60612 |
Second Address | Chicago, IL 60612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2009 |
Last Update Date | 18/11/2015 |