Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 036.152513 | IL |
NPI | 1093104523 |
---|---|
Provider Name | Omotara Sulyman |
First Address | Chicago, IL 60614-2415 |
Second Address | Chicago, IL 60614-2415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2015 |
Last Update Date | 12/01/2022 |