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Individual

MRS. AMY SUSAN PALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2515 N CLARK, CHICAGO, IL 60614
(312) 227-6060
Mailing address
BOX 107, 2300 CHILDRENS PLAZA, CHICAGO, IL 60614-3394
(312) 227-6060
(312) 227-9402

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036059158
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036059158
IL
Enumeration date
03/24/2006
Last updated
09/21/2011
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