Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 247463 | NY |
NPI | 1003087909 |
---|---|
Provider Name | Bessey Elizabeth Jose Geevarghese |
First Address | Winfield, IL 60190 |
Second Address | Chicago, IL 60611-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2008 |
Last Update Date | 09/08/2013 |