Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 036144219 | IL |
Y | 2080P0210X | Pediatric Nephrologist | 036144219 | IL |
NPI | 1164665808 |
---|---|
Provider Name | Sonia Krishnan |
First Address | Chicago, IL 60612 |
Second Address | Chicago, IL 60612-4325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2009 |
Last Update Date | 01/09/2021 |