Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 01065909 | IN |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01065909 | IN |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 036-093704 | IL |
NPI | 1104857499 |
---|---|
Provider Name | Deborah A Boyle |
First Address | Chicago, IL 60643-1814 |
Second Address | Chicago, IL 60637-1447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 27/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G8836 | (02) | IL |