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Individual

MS. THEISHA Y PERKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
364 TORRENCE AVE, CALUMET CITY, IL 60409
(708) 868-9457
(708) 868-6910
Mailing address
9119 S EXCHANGE AVE, 9718 S. HALSTED, CHICAGO, IL 60617-4225
(773) 768-5000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036106661
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036106661
IL
Enumeration date
08/28/2006
Last updated
01/27/2016
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