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1417343278
RUSSELL LLOYD AVELLANA
CHICAGO, IL
NPI
1417343278
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: WA PA60672295)
Enumeration Date
2015-04-08
Last Update Date
2016-09-06
Business Address
-- RUSSELL LLOYD AVELLANA
240 E HURON ST SUITE 1-200
CHICAGO, IL 60611-2909
Phone number: 312-503-1851
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Mailing Address
-- RUSSELL LLOYD AVELLANA
240 E HURON ST SUITE 1-200
CHICAGO, IL 60611-2909
Phone number: 312-503-1851
Copy
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