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1104933191
AUDISHO BRIMO KHOSHABA
CHICAGO, IL
NPI
1104933191
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 036078916)
Enumeration Date
2006-08-24
Last Update Date
2015-07-20
Business Address
Dr. AUDISHO BRIMO KHOSHABA M.D.
2653 W PETERSON AVE
CHICAGO, IL 60659-4017
Phone number: 773-728-9399
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Mailing Address
Dr. AUDISHO BRIMO KHOSHABA M.D.
2653 W PETERSON AVE
CHICAGO, IL 60659-4017
Phone number: 773-728-9399
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