Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | R75829 | AZ |
N | 208600000X | Surgeon | R75829 | AZ |
Y | 2086S0129X | Vascular Surgeon | 036.154827 | IL |
NPI | 1003266701 |
---|---|
Provider Name | Angela Giese |
First Address | Burr Ridge, IL 60527-6686 |
Second Address | Chicago, IL 60637-1443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2016 |
Last Update Date | 27/07/2021 |