Healthcare Provider Details

I. General information

NPI: 1427107812
Provider Name (Legal Business Name): MARGO ANTOINETTE BELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 11/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 W HARRISON ST ADMINISTRATION, SUITE 1112
CHICAGO IL
60612-3714
US

IV. Provider business mailing address

1901 W HARRISON ST DEPT OF PEDIATRICS - CHILD ADOL SUITE 1112
CHICAGO IL
60612-3723
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-6000
  • Fax: 312-864-9721
Mailing address:
  • Phone: 312-864-3579
  • Fax: 312-864-9721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number036-086432
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: