Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2006013150 | MO |
Y | 2080P0202X | Pediatric Cardiologist | 036.127605 | IL |
N | 2080P0202X | Pediatric Cardiologist | 2006013150 | MO |
NPI | 1255506614 |
---|---|
Provider Name | Mary E Mcbride |
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 | 28/04/2008 |
Last Update Date | 13/09/2011 |