Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 036-074768 | IL |
Y | 2080P0206X | Pediatric Gastroenterologist | 036-074768 | IL |
N | 2080P0206X | Pediatric Gastroenterologist | 036074768 | IL |
NPI | 1457394595 |
---|---|
Provider Name | Dr. Estella Maria Alonso |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 25/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F37232 | (02) | IL |