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Individual

LYDIA ANDREA BREEN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
211 E ONTARIO ST, SUITE #1195, CHICAGO, IL 60611
(773) 381-3421
(312) 988-9363
Mailing address
1037 W NORTHSHORE AVE, #3N, CHICAGO, IL 60626
(773) 381-3420

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1633712
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/21/2006
Last updated
07/08/2007
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