Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | IL |
NPI | 1386688109 |
---|---|
Provider Name | Mrs. Wendy Joy Brickman |
First Address | Chicago, IL 60614 |
Second Address | Chicago, IL 60614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H86347 | (02) |