Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 036.156577 | IL |
NPI | 1144683426 |
---|---|
Provider Name | Alison Maringo |
First Address | Chicago, IL 60612-3806 |
Second Address | Chicago, IL 60612-3806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2016 |
Last Update Date | 19/07/2021 |