Provider Demographics
NPI:1588629703
Name:VOS, MIRIAM BENEDICTA (MD, MSPH)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:BENEDICTA
Last Name:VOS
Suffix:
Gender:F
Credentials:MD, MSPH
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:VOS
Other - Last Name:LOUTHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MSPH
Mailing Address - Street 1:2439 N RACINE AVE
Mailing Address - Street 2:APT 306
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2132
Mailing Address - Country:US
Mailing Address - Phone:773-880-6015
Mailing Address - Fax:
Practice Address - Street 1:2300 N CHILDRENS PLZ
Practice Address - Street 2:BOX 57
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3363
Practice Address - Country:US
Practice Address - Phone:773-880-6015
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA541602080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology