Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
May 5, 2019
License(s)
125075105 (IL), 036158631 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 676 N SAINT CLAIR ST STE 800 | Chicago, IL 60611-2978 | 312-695-5753 |
| LOCATION | 676 N SAINT CLAIR ST STE 800 | Chicago, IL 60611-2978 | 312-695-5753 |
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