Organization
TABITHA A WATTS MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TABITHA A WATTS MD (PRESIDENT)
(708) 788-0077
Entity
Organization
Contact information
Practice address
6545 CERMAK RD, BERWYN, IL 60402-2313
(708) 788-0077
(708) 788-5620
Mailing address
6545 CERMAK RD, BERWYN, IL 60402-2313
(708) 788-0077
(708) 788-5620
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-108494
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036108494
—
IL
Enumeration date
10/22/2009
Last updated
10/22/2009
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