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General NPI Number Information
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NPI Number | 1033859905
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Entity Type | Individual
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Provider Name | JACQUELINE RICE MD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 06/05/2022
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Provider Practice Location Address
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Address Line | 836 W WELLINGTON AVE
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City | CHICAGO
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State | IL
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Zip | 60657-5147
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Country | US
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Telephone | 773-975-1600
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Fax |
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Provider Business Mailing Address
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Address Line | 820 S WOOD ST # MC675
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City | CHICAGO
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State | IL
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Zip | 60612-4325
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Country | US
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Telephone | 312-996-2933
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 125.079865
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License Number State | IL
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