Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036-085281 | IL |
Y | 2080P0203X | Pediatric Critical Care Doctor | 036085281 | IL |
NPI | 1043204910 |
---|---|
Provider Name | Dr. Elizabeth A Bello |
First Address | Urbana, IL 61801-2500 |
Second Address | Urbana, IL 61801-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 20/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036085281 | (05) | IL |