Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0000X | Obstetrician | 036145683 | IL |
Y | 207VX0201X | Gynecologic Oncologist | 036145683 | IL |
NPI | 1558789826 |
---|---|
Provider Name | Raanan Alter |
First Address | Warrenville, IL 60555-3269 |
Second Address | Warrenville, IL 60555-3269 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 12/11/2021 |