Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | IL |
NPI | 1295799617 |
---|---|
Provider Name | Ram Yogev |
First Address | Evanston, IL 60202 |
Second Address | Chicago, IL 60614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 04/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AY1998472 | DEA (01) | |
C47364 | (02) |