Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Nov 18, 2014
License(s)
085006090 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 5841 S MARYLAND AVE | Chicago, IL 60637-1443 | 888-824-0200 |
| MAILING | 150 HARVESTER DR SUITE 300 | Burr Ridge, IL 60527-5919 |
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