Individual
MARY ABBY ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2650 RIDGE AVE, DIVISION OF NEONATOLOGY, WALGREEN BLDG RM 1505, EVANSTON, IL 60201-1718
(847) 570-2033
(847) 570-0231
Mailing address
2650 RIDGE AVE, DIVISION OF NEONATOLOGY, WALGREEN BLDG RM 1505, EVANSTON, IL 60201-1718
(847) 570-2033
(847) 570-0231
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036054765
IL
2080N0001X
Neonatal-Perinatal Medicine Physician
036054765
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036054765
—
IL
01
—
1620385
BLUE SHIELD
IL
Enumeration date
10/19/2006
Last updated
07/02/2008
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