Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Oct 22, 2018
License(s)
085006677 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 233 E SUPERIOR ST FL 1 | Chicago, IL 60611-2913 | 312-472-1234 |
| MAILING | 233 E SUPERIOR ST FL 1 | Chicago, IL 60611-2913 | 312-472-1234 |
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