Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 036125784 | IL |
NPI | 1346401429 |
---|---|
Provider Name | Anna Beth Katz |
First Address | Libertyville, IL 60048-3204 |
Second Address | Libertyville, IL 60048-3204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2008 |
Last Update Date | 05/12/2013 |