Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 125053596 | IL |
Y | 111NI0900X | Internist | 125053596 | IL |
NPI | 1003078049 |
---|---|
Provider Name | Alexandra M Dumitrescu |
First Address | Chicago, IL 60637-1447 |
Second Address | Chicago, IL 60637-1447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2008 |
Last Update Date | 01/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
82179 | PHYSICIAN ID (01) | IL |