Deeken Draisey, Audrey
Deeken Draisey, Audrey is an sole proprietor health care provider with primary practice located at 303 E Chicago Ave # 3140W127 , Chicago IL 60611-4296. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is her primary health care specialty. Deeken Draisey, Audrey can be contacted via phone (312) 503-8144.Contact Information
Primary practice address
303 E Chicago Ave # 3140W127
Chicago IL 60611-4296
Phone: (312) 503-8144
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 036144258 | Illinois |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | X | Illinois |
Profile Details
| NPI number | 1710305560 |
|---|---|
| LBN Legal business name | Deeken Draisey, Audrey |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 30th, 2014 |
| Last updated | Apr 16th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710305560 | NPPES |
| Illinois | MEDICAID | 1710305560 |
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