DAVID JACOB NUSBAUM

CHICAGO, IL
NPI1477173540
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208800000X Urology
(Licence: IL  125075646)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2020-04-19
Last Update Date2020-04-20
Business Address
DAVID JACOB NUSBAUM
5841 S MARYLAND AVE # MC6038
CHICAGO, IL 60637-1443
Phone number: 773-702-9757
Mailing Address
DAVID JACOB NUSBAUM
180 HARVESTER DR STE 110
BURR RIDGE, IL 60527-6686
Phone number: 773-702-1150