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1508146309
CHARLES MININGER
EVANSTON, IL
NPI
1508146309
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085004089)
Enumeration Date
2011-08-24
Last Update Date
2011-08-25
Business Address
-- CHARLES MININGER
2650 RIDGE AVE
EVANSTON, IL 60201-1718
Phone number: 847-570-2000
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Mailing Address
-- CHARLES MININGER
444 W FULLERTON PKWY APT 1801
CHICAGO, IL 60614-2852
Phone number:
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