Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 1023470796 | IL |
NPI | 1023470796 |
---|---|
Provider Name | Susan Talamini |
First Address | Chicago, IL 60607-2420 |
Second Address | Chicago, IL 60612-7232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2016 |
Last Update Date | 09/09/2016 |