Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 036.121420 | IL |
N | 2080N0001X | Neonatal-Perinatal Doctor | A035710 | CA |
NPI | 1104970185 |
---|---|
Provider Name | Usha Raj |
First Address | Chicago, IL 60612-4325 |
Second Address | Chicago, IL 60612-4325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 09/06/2011 |