Provider Demographics
NPI:1609905348
Name:NORMAN, PHILIPPA (MD, MPH)
Entity Type:Individual
Prefix:
First Name:PHILIPPA
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 S RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1433
Mailing Address - Country:US
Mailing Address - Phone:773-383-5260
Mailing Address - Fax:
Practice Address - Street 1:740 S RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1433
Practice Address - Country:US
Practice Address - Phone:773-383-5260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL16893988512083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01621679OtherBCBSIL
IL036081553Medicaid
IL01621679OtherBCBSIL