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General NPI Number Information
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NPI Number | 1609832187
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Entity Type | Individual
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Provider Name | JAMES ALLEN WESTRA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 07/14/2011
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Provider Practice Location Address
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Address Line | 3001 6TH ST BUIDING 200H LABORATORY
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City | GREAT LAKES
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State | IL
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Zip | 60088-2833
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Country | US
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Telephone | 847-688-6850
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Fax | 847-688-2778
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Provider Business Mailing Address
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Address Line | 24701 EUCLID AVE 3RD FLOOR
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City | EUCLID
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State | OH
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Zip | 44117-1714
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 0101056120
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License Number State | VA
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