Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 36114888 | IL |
NPI | 1003938762 |
---|---|
Provider Name | Norma B Westervelt |
First Address | Forest Park, IL 60130-2622 |
Second Address | Chicago, IL 60608-4511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 26/09/2007 |