Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 071008032 | IL |
NPI | 1083918320 |
---|---|
Provider Name | Dr. Anne M Vierling |
First Address | Northbrook, IL 60062-2851 |
Second Address | Northbrook, IL 60062-2851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2010 |
Last Update Date | 28/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
465441022 | BCBSIL (01) | IL |