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1255190690
THEODORE LORD AGBEMAPLE
CHICAGO, IL
NPI
1255190690
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-18
Last Update Date
2024-03-18
Business Address
Dr. THEODORE LORD AGBEMAPLE MD
2900 N LAKE SHORE DR
CHICAGO, IL 60657-5640
Phone number: 773-665-3000
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Mailing Address
Dr. THEODORE LORD AGBEMAPLE MD
926 N WALNUT ST
SPRINGFIELD, IL 62702-3747
Phone number: 815-661-0642
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