Individual
DR. THEODORE REXFORD ADDAI
Active
Individual
DR. THEODORE REXFORD ADDAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036078026
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036078026
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000334245
RAILROAD
IL
05
—
036078026
—
IL
Enumeration date
01/06/2006
Last updated
12/20/2021
Update your record
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