MARK AMBROSE

HAZEL CREST, IL
NPI1043424740
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085000830)
Enumeration Date2007-05-10
Last Update Date2016-05-13
Business Address
-- MARK AMBROSE PA-C
3330 W 177TH ST SUITE 3E
HAZEL CREST, IL 60429-2184
Phone number: 708-206-0010
Mailing Address
-- MARK AMBROSE PA-C
16450 104TH AVE STE 101
ORLAND PARK, IL 60467-5416
Phone number: 708-206-0010