Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 036120566 | IL |
NPI | 1902071269 |
---|---|
Provider Name | Dr. Kavita S Hodgkins |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 10/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036120566 | (05) | IL |