Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 036140550 | IL |
NPI | 1043452287 |
---|---|
Provider Name | Samuel John Ohlander |
First Address | Chicago, IL 60612-4325 |
Second Address | Chicago, IL 60608-1202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 13/09/2016 |