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Individual

TABITHA ANN POORVU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CGC

Contact information

Practice address
680 N LAKE SHORE DR, SUITE 1230, CHICAGO, IL 60611-4546
(312) 477-2978
(312) 981-4404
Mailing address
730 S CLARK ST, APT 2512, CHICAGO, IL 60605-1743
(774) 239-1730

Taxonomy

Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
247000044
IL

Other

Enumeration date
01/04/2013
Last updated
05/17/2014
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