Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 209.016516 | IL |
NPI | 1134635147 |
---|---|
Provider Name | Margaret Connors |
First Address | Chicago, IL 60637-2612 |
Second Address | Chicago, IL 60637-1425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2017 |
Last Update Date | 28/12/2017 |