Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | IL | |
Y | 213EG0000X | General Practice | IL |
NPI | 1003853243 |
---|---|
Provider Name | Dr. Eugenie Guzman Darling |
First Address | Tinley Park, IL 60477-4450 |
Second Address | Tinley Park, IL 60477-3917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 08/07/2007 |