Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 038.012328 | IL |
NPI | 1740527449 |
---|---|
Provider Name | William Walter Anthony |
First Address | Hinsdale, IL 60521-4035 |
Second Address | Hinsdale, IL 60521-4035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2013 |
Last Update Date | 15/01/2013 |