Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 036.146268 | IL |
Y | 208600000X | Surgeon | 036.146268 | IL |
N | 2086S0102X | Surgical Critical Care | 036.146268 | IL |
NPI | 1316421324 |
---|---|
Provider Name | Dr. Erica Lester |
First Address | Chicago, IL 60605-1782 |
Second Address | Chicago, IL 60612 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2018 |
Last Update Date | 26/06/2020 |