Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 036145672 | IL |
NPI | 1164860557 |
---|---|
Provider Name | Dr. Anisha Kshetrapal |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 08/06/2021 |