Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Mar 9, 2018
License(s)
085-006550 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 29373 NETWORK PL | Chicago, IL 60673-1009 | 847-390-5900 |
| LOCATION | 1875 DEMPSTER ST STE 640 | Park Ridge, IL 60068-1179 | 847-297-6380 |
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