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Individual

BETH DAVIS PHILLPOTTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
675 W NORTH AVE, SUITE 414, MELROSE PARK, IL 60160-1634
(708) 681-7858
(708) 681-7816
Mailing address
9000 S STONY ISLAND AVE, CHICAGO, IL 60617-3508
(773) 731-0670
(773) 731-1714

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036089148
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036089148
IL
Enumeration date
11/18/2005
Last updated
01/08/2014
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