Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 036.150729 | IL |
N | 2080P0207X | Pediatric Hematology-Oncologist | 250478 | MA |
NPI | 1205062825 |
---|---|
Provider Name | Dr. Loretta Li |
First Address | Chicago, IL 60611 |
Second Address | Chicago, IL 60611-2991 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2009 |
Last Update Date | 04/12/2019 |