Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 036-123033 | IL |
Y | 111NI0900X | Internist | 036-123033 | IL |
NPI | 1003076795 |
---|---|
Provider Name | Ronald Myint |
First Address | Chicago, IL 60693-0626 |
Second Address | Oak Lawn, IL 60453-2654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2008 |
Last Update Date | 10/07/2015 |