Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Jun 27, 2018
License(s)
036156394 (IL), 0101288148 (VA), 4301515256 (MI), 125073177 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 4000 WELLNESS DR | Midland, MI 48670-1000 | 844-832-1956 |
| LOCATION | 1901 W HARRISON ST | Chicago, IL 60612-3714 | 312-864-6000 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.