Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 036056818 | IL |
NPI | 1104926245 |
---|---|
Provider Name | William C Stratton |
First Address | Urbana, IL 61801-2500 |
Second Address | Urbana, IL 61801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 13/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A03227 | (02) | |
A03227 | (02) | IL |