Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 036113505 | IL |
Y | 208600000X | Surgeon | 036113505 | IL |
NPI | 1013459742 |
---|---|
Provider Name | Seema Kumbhat |
First Address | Chicago, IL 60618-5601 |
Second Address | Lake Zurich, IL 60047-8930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2016 |
Last Update Date | 11/11/2016 |