DANIEL ROBERT WAHLSTROM

CHICAGO, IL
NPI1265013619
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084N0400X Psychiatry & Neurology, Neurology
(Licence: IL  125-078946)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-04-17
Last Update Date2021-06-23
Business Address
DANIEL ROBERT WAHLSTROM
600 S PAULINA ST STE 403
CHICAGO, IL 60612-3806
Phone number: 312-942-7100
Mailing Address
DANIEL ROBERT WAHLSTROM
600 S PAULINA ST STE 403
CHICAGO, IL 60612-3806
Phone number: