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1174930887
THOMPSON DZIDZA
CHICAGO, IL
NPI
1174930887
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085.005067)
Enumeration Date
2014-07-14
Last Update Date
2021-01-10
Business Address
-- THOMPSON DZIDZA PA
925 W 53RD ST
CHICAGO, IL 60609-6109
Phone number: 773-727-7548
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Mailing Address
-- THOMPSON DZIDZA PA
925 W 53RD ST
CHICAGO, IL 60609-6109
Phone number: 773-727-7548
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