Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 036.142222 | IL |
NPI | 1083952618 |
---|---|
Provider Name | Maria Claudia Moscoso Cordero |
First Address | Skokie, IL 60077-1057 |
Second Address | Skokie, IL 60077 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2013 |
Last Update Date | 17/09/2019 |