Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 036108579 | IL |
N | 208000000X | Pediatrician | 036-108579 | IL |
NPI | 1417971268 |
---|---|
Provider Name | Mrs. Rebecca Ruhana Burns |
First Address | Chicago, IL 60640-4405 |
Second Address | Chicago, IL 60614-3363 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 05/03/2021 |