Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 036155173 | IL |
N | 2084N0400X | Neurologist | 125070638 | IL |
Y | 2084N0600X | Clinical Neurophysiologist | 036155173 | IL |
NPI | 1013448901 |
---|---|
Provider Name | Erin Rebecca Fiedler |
First Address | Burr Ridge, IL 60527-6686 |
Second Address | Chicago, IL 60637-1443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2017 |
Last Update Date | 27/06/2021 |