Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 036-120605 | IL |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 036-120605 | IL |
NPI | 1538388830 |
---|---|
Provider Name | Vineeta Theresa Swaroop |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2007 |
Last Update Date | 31/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036120605-1 | (05) | IL |
036120605-2 | (05) | IL |