Individual
KORI SUMMERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1460 N. HALSTED ST, SUITE 402, CHICAGO, IL 60642
(312) 279-8900
(312) 981-6312
Mailing address
1460 N. HALSTED ST, SUITE 402, CHICAGO, IL 60642
(312) 279-8900
(312) 981-6312
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125-053990
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125-053990
STATE LICENSE NUMBER
IL
Enumeration date
07/30/2008
Last updated
09/23/2011
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