Individual
JULIA CORCORAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1801 W TAYLOR ST, 3F OCC MC 741, CHICAGO, IL 60612-4795
(312) 996-9313
Mailing address
840 S WOOD ST, MC 958, CHICAGO, IL 60612-4325
(312) 996-9313
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036082569
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036082569
—
IL
01
—
1627123
BCBS PROVIDER ID
IL
01
—
363283051
OWCP PROVIDER ID
IL
Enumeration date
09/16/2005
Last updated
04/25/2017
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