Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 027582 | CT |
NPI | 1043767841 |
---|---|
Provider Name | Dr. Gail Sharon Haiken |
First Address | Rockford, IL 61107-5092 |
Second Address | Rockford, IL 61107-5092 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2016 |
Last Update Date | 08/09/2016 |