Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | IL |
NPI | 1255463451 |
---|---|
Provider Name | Jennifer C. Obel |
First Address | Evanston, IL 60201-1718 |
Second Address | Evanston, IL 60201-1718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 08/07/2007 |