Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | IL |
NPI | 1639154156 |
---|---|
Provider Name | Dr. Laura Helen Rogers |
First Address | Chicago, IL 60611-2926 |
Second Address | Chicago, IL 60611-2926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1634854 | (02) | IL |