Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036139314 | IL |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 036139314 | IL |
NPI | 1063787398 |
---|---|
Provider Name | Ana Claudia Taddei |
First Address | Evanston, IL 60201-1700 |
Second Address | Evanston, IL 60201-1700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2012 |
Last Update Date | 03/02/2022 |