Provider Demographics
NPI:1427107812
Name:BELL, MARGO ANTOINETTE (MD)
Entity type:Individual
Prefix:
First Name:MARGO
Middle Name:ANTOINETTE
Last Name:BELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1901 W HARRISON ST DEPT OF PEDIATRICS - CHILD ADOL
Mailing Address - Street 2:SUITE 1112
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3723
Mailing Address - Country:US
Mailing Address - Phone:312-864-3579
Mailing Address - Fax:312-864-9721
Practice Address - Street 1:1901 W HARRISON ST
Practice Address - Street 2:ADMINISTRATION, SUITE 1112
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3714
Practice Address - Country:US
Practice Address - Phone:312-864-6000
Practice Address - Fax:312-864-9721
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-0864322080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH35880Medicare UPIN