MARIAM PESTVENIDZE

EVANSTON, IL
NPI1427896679
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL  125.083823)
Enumeration Date2024-07-19
Last Update Date2024-07-19
Business Address
MARIAM PESTVENIDZE M.D.
355 RIDGE AVE
EVANSTON, IL 60202-3328
Phone number: 847-316-6228
Mailing Address
MARIAM PESTVENIDZE M.D.
419 RIDGE AVE APT H
EVANSTON, IL 60202-2852
Phone number: 224-500-9763
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