Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Dec 12, 2006
License(s)
085-001716 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1425 N HUNT CLUB RD STE 100 | Gurnee, IL 60031-2632 | 847-548-2200 |
| MAILING | 1425 N HUNT CLUB RD STE 100 | Gurnee, IL 60031-2632 | 847-548-2200 |
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