Registry details
Type
Individual
Primary specialty
Surgery
Enumerated
May 23, 2012
License(s)
036.125620 (IL), 036125620 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1900 W POLK ST STE 625 | Chicago, IL 60612-3723 | 312-903-0204 |
| LOCATION | 1900 W POLK ST STE 625 | Chicago, IL 60612-3723 | 312-903-0204 |
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