Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 125052680 | IL |
N | 208000000X | Pediatrician | D74340 | MD |
N | 2080P0214X | Pediatric Pulmonologist | D74340 | MD |
NPI | 1417113069 |
---|---|
Provider Name | Anna B Fishbein |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2008 |
Last Update Date | 18/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202402100 | (05) | MD |