Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 036-074347 | IL |
NPI | 1083639736 |
---|---|
Provider Name | Dr. Susan Concepcion Echiverri |
First Address | Warrenville, IL 60555-2740 |
Second Address | Chicago, IL 60612-3714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 06/03/2013 |