Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
Aug 22, 2006
License(s)
036-066460 (IL), 036-066460 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 2211 N. OAK PARK AVENUE | Chicago, IL 60707-3392 | 773-385-5491 |
| MAILING | PO BOX 8500, LOCKBOX 7642 | Philadelphia, PA 19178-7642 | 813-281-8115 |
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