Individual
ARLENE D'SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
304 RANDALL RD, GENEVA, IL 60134-4200
(630) 232-0610
Mailing address
304 RANDALL RD, GENEVA, IL 60134-4200
(630) 232-0610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125-055744
IL
207RH0000X
Hematology (Internal Medicine) Physician
036138969
IL
207RH0003X
Hematology & Oncology Physician
Primary
036138969
IL
207RX0202X
Medical Oncology Physician
036138969
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036138969
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400245116
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
05/13/2009
Last updated
02/19/2018
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