Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | IL | |
N | 111NI0900X | Internist | IL | |
N | 207RG0300X | Geriatric Medicine | IL | |
N | 207RH0002X | Hospice and Palliative Medicine | IL |
NPI | 1043354517 |
---|---|
Provider Name | Dr. Terry Lynn Clarbour |
First Address | Oak Park, IL 60302-3453 |
Second Address | Oak Park, IL 60302-3453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H72905 | (02) |