Basic Information
| Provider Information | |||||||||
| NPI: | 1366778276 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIESEN | ||||||||
| FirstName: | URSULA | ||||||||
| MiddleName: | ELISABETH | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5721 S MARYLAND AVE | ||||||||
| Address2: | MC 8016 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606371425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7737026435 | ||||||||
| FaxNumber: | 7738340748 | ||||||||
| Practice Location | |||||||||
| Address1: | 5721 S MARYLAND AVE | ||||||||
| Address2: | MC 8016 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606371425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7737026435 | ||||||||
| FaxNumber: | 7738340748 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2009 | ||||||||
| LastUpdateDate: | 10/28/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 125052804 | IL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.