Individual
DR. TRISH L. PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1611 W HARRISON, SUITE 400, CHICAGO, IL 60612
(312) 243-4244
(312) 942-1517
Mailing address
1 WESTBROOK CORPORATE CTR, #240, WESTCHESTER, IL 60154-5701
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036096275
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096275 1
—
IL
01
—
1633878
BCBS GROUP ID#
IL
01
—
207067
MEDICARE PTAN LOCALITY 16
IL
01
—
207073
MEDICARE PTAN LOCALITY 15
IL
01
—
5647658
AETNA ID#
IL
01
—
DA4902
RR MEDICARE PTAN#
IL
01
—
P00295720
RR MEDICARE ID#
IL
Enumeration date
01/11/2006
Last updated
12/07/2009
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