Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | IL |
NPI | 1124179882 |
---|---|
Provider Name | Dr. Karen M Balzanto |
First Address | St Charles, IL 60174-8786 |
Second Address | Naperville, IL 60540-7430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |