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1518607696
2001-15 N PARKSIDE LLC
CHICAGO, IL
NPI
1518607696
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Entity Type
Organization
Authorized Contact
MONA KHAN
Physician
312-955-4005
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
Enumeration Date
2022-03-29
Last Update Date
2022-03-29
Business Address
2001-15 N PARKSIDE LLC
405 N WABASH AVE STE P2-A
CHICAGO, IL 60611-3744
Phone number: 312-955-4005
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Mailing Address
2001-15 N PARKSIDE LLC
18140 AUDETTE ST
DEARBORN, MI 48124-4217
Phone number: 312-998-5229
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