Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 209008554 | IL |
NPI | 1346544707 |
---|---|
Provider Name | Mrs. Sylbi Intarakumhang |
First Address | Park Ridge, IL 60068-4517 |
Second Address | Chicago, IL 60611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2010 |
Last Update Date | 25/04/2019 |