Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 036-156167 | IL |
N | 207X00000X | Orthopaedic Surgeon | 125066838 | IL |
NPI | 1023499480 |
---|---|
Provider Name | William Mosenthal |
First Address | Des Plaines, IL 60016-2359 |
Second Address | Bradley, IL 60915-2685 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2015 |
Last Update Date | 10/08/2021 |