Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 209011310 | IL |
NPI | 1043636756 |
---|---|
Provider Name | Danielle Basinger Lam |
First Address | Chicago, IL 60613-2613 |
Second Address | Chicago, IL 60611-2908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2014 |
Last Update Date | 28/10/2020 |