Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Apr 12, 2016
License(s)
MD489834 (DE), R75471 (AZ), 036156431 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 250 E SUPERIOR ST RM 4-2304 | Chicago, IL 60611-2914 | 312-926-9451 |
| LOCATION | 251 E HURON ST | Chicago, IL 60611-3055 | 312-926-9451 |
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