Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 056.003598 | IL |
NPI | 1902189855 |
---|---|
Provider Name | Ms. Janette Frances Gilmartin |
First Address | Chicago, IL 60622-3507 |
Second Address | Chicago, IL 60622-3507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2011 |
Last Update Date | 27/09/2011 |