Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 036120992 | IL |
N | 2080N0001X | Neonatal-Perinatal Doctor | 224019 | MA |
NPI | 1053360974 |
---|---|
Provider Name | Dr. Debra Beth Selip |
First Address | Chicago, IL 60612-3833 |
Second Address | Chicago, IL 60612-3833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 13/06/2011 |