Organization
TABITHA WATTS MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TABITHA ANN WATTS M.D. (PRESIDENT)
(312) 451-5695
Entity
Organization
Contact information
Practice address
4177 S ARCHER AVE, CHICAGO, IL 60632-1849
(773) 932-1142
(773) 902-1104
Mailing address
PO BOX 4645, CHICAGO, IL 60680-4645
(773) 932-1142
(312) 264-0662
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/27/2011
Last updated
11/27/2011
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