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General NPI Number Information
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NPI Number | 1285718718
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Entity Type | Organization
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Legal Business Name | VENUS C PAXTON MD
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4840 N MARINE DR
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City | CHICAGO
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State | IL
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Zip | 60640-7860
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Country | US
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Telephone | 773-878-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 4840 N MARINE DR
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City | CHICAGO
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State | IL
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Zip | 60640-7860
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Country | US
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Telephone | 773-878-9700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VENUS C PAXTON
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Credential | MD
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Telephone | 773-878-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State | IL
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