Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036.132125 | IL |
N | 111NI0900X | Internist | 036.132125 | IL |
Y | 207RI0200X | Infectious Disease | 036132125 | IL |
N | 208000000X | Pediatrician | 036.132125 | IL |
N | 2080P0208X | Pediatric Infectious Diseases | 036132125 | IL |
NPI | 1336378348 |
---|---|
Provider Name | Dr. Mary Ellen Acree |
First Address | Evanston, IL 60201-1780 |
Second Address | Evanston, IL 60201-1780 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2009 |
Last Update Date | 07/04/2021 |