Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | MD424701 | PA |
NPI | 1215120605 |
---|---|
Provider Name | Jennifer Reichek |
First Address | Chicago, IL 60614-3363 |
Second Address | Chicago, IL 60614-3363 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2007 |
Last Update Date | 04/10/2011 |