Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Aug 11, 2008
License(s)
085005030 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 251 E HURON ST STE 16-738 | Chicago, IL 60611-2908 | 312-926-5924 |
| MAILING | 251 E HURON ST STE 16-738 | Chicago, IL 60611-2908 | 312-926-5924 |
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