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NPI Code Detail

MEDICARE: EDITH H HARTE MD OBGYN

MEDICARE: EDITH H HARTE MD OBGYN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician35079857HOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164461935
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDITH H HARTE MD OBGYN
Provider Business Mailing Address
First Line : 1701 WEST SUPERIOR ST.
Second Line : ERIE FAMILY HEALTH CENTER
City : CHICAGO
State : IL
Zip : 60622-5646
Country : US
Telephone Number : 312-432-7392
Fax Number : 312-666-6228
Provider Business Practice Location Address
First Line : 1701 W SUPERIOR ST
Second Line : ERIE FAMILY HEALTH CENTER
City : CHICAGO
State : IL
Zip : 60622-5646
Country : US
Telephone Number : 312-432-7392
Fax Number : 312-666-6228
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 07/08/2007

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