Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 036-098294 | IL |
NPI | 1013997345 |
---|---|
Provider Name | Dr. Inbar Kirson |
First Address | Northbrook, IL 60062-2820 |
Second Address | Northbrook, IL 60062-2820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 05/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
748450 | PROVIDER GROUP MEDICARE (01) | IL |
H22216 | (02) | IL |