Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | IL |
NPI | 1063535003 |
---|---|
Provider Name | Dr. Geraldine Ann Difranco |
First Address | Palos Hills, IL 60465-1560 |
Second Address | Palos Hills, IL 60465-1560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 08/07/2007 |