Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Feb 5, 2025
License(s)
—
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 8234 S ASHLAND AVE | Chicago, IL 60620-4625 | 773-874-1400 |
| MAILING | 8234 S ASHLAND AVE | Chicago, IL 60620-4625 |
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