Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 036131161 | IL |
NPI | 1063509172 |
---|---|
Provider Name | Richard D'aquila |
First Address | Chicago, IL 60611-3015 |
Second Address | Chicago, IL 60611-3015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 16/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D88757 | (02) |