Provider Demographics
NPI:1033104955
Name:LABELLA, CYNTHIA (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:LABELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:225 E CHICAGO AVE # 69
Mailing Address - Street 2:LURIE CHILDREN'S HOSPITAL OF CHICAGO
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2991
Mailing Address - Country:US
Mailing Address - Phone:312-227-6190
Mailing Address - Fax:312-227-9404
Practice Address - Street 1:225 E CHICAGO AVE # 69
Practice Address - Street 2:LURIE CHILDREN'S HOSPITAL OF CHICAGO
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2991
Practice Address - Country:US
Practice Address - Phone:312-227-6190
Practice Address - Fax:312-227-9404
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2013-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036-105128207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG59485Medicare UPIN