Provider Demographics
NPI:1518657733
Name:PILATE, PORSHA (MD)
Entity Type:Individual
Prefix:DR
First Name:PORSHA
Middle Name:
Last Name:PILATE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1326 S MICHIGAN AVE APT 3506
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3529
Mailing Address - Country:US
Mailing Address - Phone:773-322-6129
Mailing Address - Fax:
Practice Address - Street 1:1326 S MICHIGAN AVE APT 3506
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3529
Practice Address - Country:US
Practice Address - Phone:773-322-6129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program