Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 036157223 | IL |
NPI | 1265964829 |
---|---|
Provider Name | Erika Raley |
First Address | Chicago, IL 60612-3806 |
Second Address | Washington, DC 20060-3152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2017 |
Last Update Date | 22/06/2021 |