Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | 036072766 | IL |
NPI | 1144249764 |
---|---|
Provider Name | Sigmund Weitzman |
First Address | Chicago, IL 60611-4546 |
Second Address | Chicago, IL 60611-2927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 17/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B98702 | (02) |