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Individual

DR. MARCIE ANN CLAYBON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
600 W. CHICAGO AVE., SUITE 001, CHICAGO, IL 60654-2802
(312) 625-0845
Mailing address
600 W. CHICAGO AVE., SUITE 001, CHICAGO, IL 60654-2802
(312) 625-0845

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036.138794
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000000
PRACTICE IS NOT INSURANCE-BASED
01
036.138794
IL LICENSE #
IL
01
1831344373
NPI
IL
Enumeration date
11/25/2008
Last updated
11/05/2020
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