Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 036091042 | IL |
NPI | 1053370890 |
---|---|
Provider Name | Sarah Lynn Chamlin |
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 | 21/03/2006 |
Last Update Date | 21/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036091042 | (05) | IL |
H26993 | (02) |