Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 336093650 | IL |
Y | 2080P0214X | Pediatric Pulmonologist | 336093650 | IL |
N | 2080P0214X | Pediatric Pulmonologist | 60642631 | WA |
NPI | 1588989750 |
---|---|
Provider Name | Matthew Farris Abts |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611-2991 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2010 |
Last Update Date | 19/04/2016 |