Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 67082 | WI |
NPI | 1164764874 |
---|---|
Provider Name | Rachel Katherine Harrison |
First Address | Oak Lawn, IL 60453-2658 |
Second Address | Oak Lawn, IL 60453-2658 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2013 |
Last Update Date | 15/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1164764874 | (05) | WI |