Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | DO2582 | NV |
NPI | 1255674065 |
---|---|
Provider Name | Elizabeth Ann Nakae |
First Address | Park Ridge, IL 60068-1110 |
Second Address | Park Ridge, IL 60068-1110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2013 |
Last Update Date | 26/07/2019 |