Individual
DEVRAJ BANERJEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
812 LARAMIE AVE, WILMETTE, IL 60091-2054
(347) 729-2764
Mailing address
812 LARAMIE AVE, WILMETTE, IL 60091-2054
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238000562
IL
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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