Provider Demographics
NPI:1679668362
Name:KIRSCHNER, CAROLYN V (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:V
Last Name:KIRSCHNER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:KELLOGG CANCER CENTER
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-2639
Mailing Address - Fax:847-733-5618
Practice Address - Street 1:2650 RIDGE AVE
Practice Address - Street 2:KELLOGG CANCER CENTER
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-1718
Practice Address - Country:US
Practice Address - Phone:847-570-2639
Practice Address - Fax:847-733-5618
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-02-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036068601207V00000X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC43125Medicare UPIN