Provider Demographics
NPI:1629061114
Name:KIRBY, JOANNE C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:C
Last Name:KIRBY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:259 E ERIE ST
Mailing Address - Street 2:SUITE 2330
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2987
Mailing Address - Country:US
Mailing Address - Phone:312-926-6000
Mailing Address - Fax:312-926-5971
Practice Address - Street 1:259 E ERIE ST
Practice Address - Street 2:SUITE 2330
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2987
Practice Address - Country:US
Practice Address - Phone:312-926-6000
Practice Address - Fax:312-926-5971
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036073378207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036073378Medicaid
IL110079643OtherRR MEDICARE
IL036073378Medicaid