Individual
ANNAMMA MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1158 W TAYLOR ST, CHICAGO, IL 60607-4213
(312) 455-8640
(312) 455-2806
Mailing address
1158 W TAYLOR ST, CHICAGO, IL 60607-4213
(312) 455-8640
(312) 455-2806
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-086152
IL
Other
Enumeration date
10/20/2006
Last updated
05/13/2012
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