Dr. Carol Witcraft Booth
Clinical Genetics (M.D.)
1875 Dempster St Suite 310
Park Ridge
, Illinois 60068-1186
Dr. Carol Witcraft Booth
Clinical Genetics (M.D.)
1875 Dempster St Suite 310
Park Ridge
, Illinois 60068-1186
(847) 723-8675
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About
Features
Specialties
- Clinical Genetics (M.D.)
Languages spoken
- English
Location
First Address
- Dr. Carol Witcraft Booth
- 1875 Dempster St Suite 310
- Park Ridge, IL
- Zip : 60068-1186
- Fax : (847) 723-8675
- Phone : (847) 723-7705
Second Address
- Dr. Carol Witcraft Booth
- 1875 Dempster St Suite 310
- Park Ridge, IL
- Zip : 60068-1186
- Fax : (847) 723-8675
- Phone : (847) 723-7705
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207SG0201X | Clinical Genetics (M.D.) | 036042710 | IL |
National Provider Identifier
| NPI | 1225072598 |
|---|---|
| Provider Name | Dr. Carol Witcraft Booth |
| First Address | Park Ridge, IL 60068-1186 |
| Second Address | Park Ridge, IL 60068-1186 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/06/2006 |
| Last Update Date | 10/03/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036042710 | (05) | IL |
| 460002585 | RR MED PIN (01) | |
| C19354 | RR MED GROUP (01) | |
| C39489 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.