Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 036.131932 | IL |
NPI | 1043338395 |
---|---|
Provider Name | Nora Taylor Maczura |
First Address | Springfield, IL 62703-2403 |
Second Address | Springfield, IL 62702-3749 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 21/05/2020 |