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Individual

MRS. SUSAN H PORTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2600 S MICHIGAN AVE, 305, CHICAGO, IL 60616-2857
(312) 326-4500
(312) 326-1200
Mailing address
2600 S MICHIGAN AVE, 305, CHICAGO, IL 60616-2857
(312) 326-4500
(312) 326-1200

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036074744
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036074744
IL
Enumeration date
10/20/2005
Last updated
05/27/2022
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