Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 019026263 | IL |
Y | 213EG0000X | General Practice | 019026263 | IL |
NPI | 1003116054 |
---|---|
Provider Name | Dr. Gerilyn Alfe |
First Address | Chicago, IL 60614-1414 |
Second Address | Chicago, IL 60614-1414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2010 |
Last Update Date | 25/10/2010 |