SPENCER GRANT SUPPES

CHICAGO, IL
NPI1144842279
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL  125.076420)
Enumeration Date2020-05-12
Last Update Date2020-05-12
Business Address
SPENCER GRANT SUPPES DO
5140 N CALIFORNIA AVE
CHICAGO, IL 60625-3645
Phone number: 773-878-8200
Mailing Address
SPENCER GRANT SUPPES DO
1025 W ADDISON ST APT 609
CHICAGO, IL 60613-5185
Phone number:
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