Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036126838 | IL |
Y | 2080P0205X | Pediatric Endocrinologist | 036126838 | IL |
N | 2080P0205X | Pediatric Endocrinologist | 245144 | NY |
NPI | 1437383528 |
---|---|
Provider Name | Dr. Claudia Cheryl Boucher-Berry |
First Address | Chicago, IL 60612-4325 |
Second Address | Chicago, IL 60612-4325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2009 |
Last Update Date | 18/01/2022 |