Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 036128079 | IL |
NPI | 1275709438 |
---|---|
Provider Name | Dr. Abigail Kirsten Tarbox |
First Address | Chicago, IL 60611-3375 |
Second Address | Chicago, IL 60611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2008 |
Last Update Date | 15/08/2011 |