Provider Demographics
NPI:1306132089
Name:AUFFENBERG, CAROLYN ELAINE (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:ELAINE
Last Name:AUFFENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:ELAINE
Other - Last Name:KRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1340 N ASTOR ST
Mailing Address - Street 2:#1508
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-2171
Mailing Address - Country:US
Mailing Address - Phone:630-707-0820
Mailing Address - Fax:
Practice Address - Street 1:446 E ONTARIO ST
Practice Address - Street 2:SUITE 7-100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4418
Practice Address - Country:US
Practice Address - Phone:312-926-5497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1250595522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry