Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 036111154 | IL |
NPI | 1053427252 |
---|---|
Provider Name | Karen C White |
First Address | Urbana, IL 61801-2500 |
Second Address | Urbana, IL 61801-2500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 16/05/2014 |