Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | 336084064 | IL |
NPI | 1376751255 |
---|---|
Provider Name | Dr. Beth Ann Adams |
First Address | Chicago, IL 60707-4305 |
Second Address | Buffalo Grove, IL 60089-4541 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 03/01/2019 |