Individual
MARY KATHERINE SCOTT SIEBENALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, FAAP
Contact information
Practice address
225 E CHICAGO AVE # 152, CHICAGO, IL 60611
(312) 227-7408
Mailing address
225 E CHICAGO AVE # 152, CHICAGO, IL 60611-2991
(312) 227-7408
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A119823
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
014994200
—
FL
Enumeration date
05/02/2013
Last updated
07/20/2018
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