Healthcare Provider Details

I. General information

NPI: 1316624042
Provider Name (Legal Business Name): HAVVA GOKCE TERZIOGLU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2023
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 N CLEVELAND AVE APT 1406
CHICAGO IL
60610-3664
US

IV. Provider business mailing address

857 N HOYNE AVE APT 2
CHICAGO IL
60622-5368
US

V. Phone/Fax

Practice location:
  • Phone: 312-560-8085
  • Fax:
Mailing address:
  • Phone: 312-560-8085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number125082208
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number125.082208
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: