Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 036149155 | IL |
N | 207VX0201X | Gynecologic Oncologist | 270186 | MA |
NPI | 1336395888 |
---|---|
Provider Name | Tanya M. Pulver |
First Address | Chicago, IL 60657-6704 |
Second Address | Chicago, IL 60657-6704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2008 |
Last Update Date | 17/12/2021 |