Provider Demographics
NPI:1205986486
Name:TAYLOR, JULIE V (MD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:V
Last Name:TAYLOR
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 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:847-390-4757
Practice Address - Street 1:901 E 95TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-7861
Practice Address - Country:US
Practice Address - Phone:312-878-9240
Practice Address - Fax:312-878-9241
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036085106207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL40544OtherADVOCATE HEALTH PARTNERS
IL036085106Medicaid
IL5545135002OtherCIGNA
ILP00142272OtherMEDICARE RAILROAD
IL1632088OtherBCBS
IL5240659OtherAETNA
IL40544OtherADVOCATE HEALTH PARTNERS
IL5545135002OtherCIGNA