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1366176612
HANNA MARIE KINGSTAD
EVANSTON, IL
NPI
1366176612
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: IL 085010156)
Enumeration Date
2022-07-13
Last Update Date
2024-02-06
Business Address
HANNA MARIE KINGSTAD
2650 RIDGE AVE. WALGREEN 3507
EVANSTON, IL 60201-1718
Phone number: 847-570-2827
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Mailing Address
HANNA MARIE KINGSTAD
2650 RIDGE AVE. WALGREEN 3507
EVANSTON, IL 60201-1718
Phone number: 847-570-2827
Copy
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