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Individual

DR. ERIKA LARAINE DAYANGHIRANG CHICO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1501 S CALIFORNIA AVE STE L1026, CHICAGO, IL 60608-1732
(773) 202-5760
Mailing address
1501 S CALIFORNIA AVE STE L1026, CHICAGO, IL 60608-1732
(773) 257-6097

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.069842
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125.069842
TEMPORARY LICENSE
IL
Enumeration date
07/12/2017
Last updated
07/12/2017
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