Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 036085872 | IL |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 036085872 | IL |
NPI | 1114913910 |
---|---|
Provider Name | Troy R. Karlsson |
First Address | Chicago, IL 60674-3698 |
Second Address | Naperville, IL 60540-8904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036085872 | (05) | IL |
200013547 | RAILROAD MEDICARE (01) | IL |
F52152 | (02) | IL |