Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 036-140006 | IL |
N | 207RH0002X | Hospice and Palliative Medicine | 036-140006 | IL |
NPI | 1033452479 |
---|---|
Provider Name | Katherine Tabor O'brien |
First Address | Chicago, IL 60611-5929 |
Second Address | Chicago, IL 60611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2013 |
Last Update Date | 24/06/2018 |