Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Aug 15, 2006
License(s)
085001443 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 4201 W MEDICAL CENTER DR | Mchenry, IL 60050-8409 | 815-759-3100 |
| MAILING | 4201 W MEDICAL CENTER DR | Mchenry, IL 60050-8409 | 815-759-3100 |
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