Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 038.013395 | IL |
NPI | 1265085575 |
---|---|
Provider Name | Dr. Paige Alexandria Enwright |
First Address | Pleasant Prairie, WI 53158-3737 |
Second Address | Lake Bluff, IL 60044-1600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2019 |
Last Update Date | 17/07/2019 |