Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 036-109127 | IL |
NPI | 1013993336 |
---|---|
Provider Name | Tiffany A. Karas |
First Address | Geneva, IL 60134-4209 |
Second Address | Geneva, IL 60134-4209 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 09/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036109127 | (05) | IL |
036-109127 | IL STATE LICENSE # (01) | IL |
206147 | MEDICARE PTAN (GROUP) (01) | IL |
206147108 | MEDICARE PTAN (INDIVIDUAL) (01) | IL |
I46300 | (02) | |
K23065 | (02) | IL |
P01144156 | RAILROAD MEDICARE INDIVIDUAL PTAN (01) | IL |