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1053836783
BIANCA ALEXANDRIA DOHERTY
CHICAGO, IL
NPI
1053836783
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085.006228)
Enumeration Date
2017-08-03
Last Update Date
2017-11-20
Business Address
BIANCA ALEXANDRIA DOHERTY PA-C
2073 N CLYBOURN AVE
CHICAGO, IL 60614-4003
Phone number: 773-665-4016
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Mailing Address
BIANCA ALEXANDRIA DOHERTY PA-C
3909 N WESTERN AVE
CHICAGO, IL 60618-3741
Phone number: 773-739-9200
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