Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 125-060977 | IL |
N | 207P00000X | Emergency Physician | 64494 | WI |
NPI | 1003179466 |
---|---|
Provider Name | Dr. Gillian E Munitz |
First Address | Chicago, IL 60654-3432 |
Second Address | Chicago, IL 60654-3432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2012 |
Last Update Date | 21/09/2015 |