Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 036.136905 | IL |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 263313 | MA |
NPI | 1023329240 |
---|---|
Provider Name | Dr. Whitney E. Liddy |
First Address | Chicago, IL 60611-4546 |
Second Address | Chicago, IL 60611-2927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 10/06/2016 |