Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 036085344 | IL |
NPI | 1386730745 |
---|---|
Provider Name | Ronda J Oram |
First Address | Park Ridge, IL 60068-1110 |
Second Address | Park Ridge, IL 60068-1110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 15/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F65361 | (02) | IL |