Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Apr 9, 2024
License(s)
125087228 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2160 S 1ST AVE | Maywood, IL 60153-3328 | |
| LOCATION | 2160 S 1ST AVE | Maywood, IL 60153-3328 | 708-216-3208 |
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