Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 053985 | CT |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 036146956 | IL |
NPI | 1710271341 |
---|---|
Provider Name | Dr. Marian Giselle Acevedo Alvarez |
First Address | Maywood, IL 60153-3328 |
Second Address | Maywood, IL 60153-3328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2011 |
Last Update Date | 25/10/2020 |