Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | IL |
NPI | 1093882458 |
---|---|
Provider Name | Dr. Usha Sriram |
First Address | Oak Park, IL 60302-3110 |
Second Address | Chicago, IL 60614-1413 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |