Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036130640 | IL |
N | 208000000X | Pediatrician | 125058778 | IL |
Y | 2080P0208X | Pediatric Infectious Diseases | 036-130640 | IL |
NPI | 1609187707 |
---|---|
Provider Name | Dr. Marielle Fricchione |
First Address | Chicago, IL 60612-4219 |
Second Address | Chicago, IL 60612-4219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 29/07/2020 |