Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 036114128 | IL |
NPI | 1013956630 |
---|---|
Provider Name | Catherine Chen |
First Address | Chicago, IL 60611-4546 |
Second Address | Chicago, IL 60611-4546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 09/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036-114128 | (05) | IL |
I39998 | (02) |