Registry details
Type
Organization
Primary specialty
Family Medicine
Enumerated
Jan 2, 2013
License(s)
209011079 (IL), 038011556 (IL), 036112926 (IL), 036060139 (IL), 085003927 (IL), 036134095 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1147 S WABASH AVE STE 250 | Chicago, IL 60605-2355 | 312-987-4878 |
| LOCATION | 1147 S WABASH AVE STE 250 | Chicago, IL 60605-2355 | 312-987-4878 |
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