Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 036052195 | IL |
NPI | 1013010966 |
---|---|
Provider Name | Mary Jane Cipriani |
First Address | Hines, IL 60141-7000 |
Second Address | Hines, IL 60141-7000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C45503 | (02) | IL |