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1073381166
ETHAN JAMES KSIAZEK
CHICAGO, IL
NPI
1073381166
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: IA 085010244)
Enumeration Date
2023-12-18
Last Update Date
2024-04-25
Business Address
Mr. ETHAN JAMES KSIAZEK PA-C
225 E CHICAGO AVE
CHICAGO, IL 60611-2991
Phone number: 312-227-4000
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Mailing Address
Mr. ETHAN JAMES KSIAZEK PA-C
225 E CHICAGO AVE
CHICAGO, IL 60611-2991
Phone number: 312-227-4000
Copy
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