Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | 036.146559 | IL |
Y | 2080P0216X | Pediatric Rheumatologist | 036.146559 | IL |
NPI | 1114247087 |
---|---|
Provider Name | Cuoghi C Edens |
First Address | Burr Ridge, IL 60527-5965 |
Second Address | Chicago, IL 60637-1443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2010 |
Last Update Date | 03/12/2018 |