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General NPI Number Information
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NPI Number | 1750469987
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Entity Type | Individual
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Provider Name | TABITHA A WATTS M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 1449 S MICHIGAN AVE # 1307
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City | CHICAGO
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State | IL
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Zip | 60605-2810
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Country | US
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Telephone | 888-437-2682
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Fax | 312-264-0662
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Provider Business Mailing Address
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Address Line | PO BOX 4645
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City | CHICAGO
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State | IL
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Zip | 60680-4645
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Country | US
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Telephone | 312-451-5695
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Fax | 312-264-0662
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 137-320
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01092245A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 036-108494
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01092245A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036-108494
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License Number State | IL
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