Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 036.158325 | IL |
NPI | 1003339482 |
---|---|
Provider Name | Mrs. Maria Luisa Safar Boueri |
First Address | Chicago, IL 60611-2927 |
Second Address | Chicago, IL 60611-2927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2017 |
Last Update Date | 03/02/2022 |