Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 036.046277 | IL |
NPI | 1003079211 |
---|---|
Provider Name | Rene Pecson |
First Address | Arlington Heights, IL 60004-2664 |
Second Address | Arlington Heights, IL 60004-2664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2008 |
Last Update Date | 08/07/2008 |