Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 01075881A | IN |
Y | 207RR0500X | Rheumatology | 036099061 | IL |
NPI | 1043309123 |
---|---|
Provider Name | Raheemuddin Nazeer |
First Address | Geneva, IL 60134-2578 |
Second Address | Geneva, IL 60134-0020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 30/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201324520 | (05) | IN |
H13784 | (02) | IN |