Individual
MARY TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD MPH
Contact information
Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(312) 864-4963
Mailing address
250 E SUPERIOR ST, CHICAGO, IL 60611-2914
(312) 926-2000
(312) 472-0141
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036.161261
IL
Other
Enumeration date
03/18/2018
Last updated
09/28/2022
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