NILS A EASTBURG

CHICAGO, IL
NPI1023691300
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  125082277)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-05-04
Last Update Date2023-07-17
Business Address
NILS A EASTBURG
3860 W OGDEN AVE
CHICAGO, IL 60623-2460
Phone number: 872-588-3000
Mailing Address
NILS A EASTBURG
600 S PAULINA ST STE 403
CHICAGO, IL 60612-3806
Phone number: