JACKIE TA

CHICAGO, IL
NPI1649652165
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: IL  125067630)
Enumeration Date2015-06-20
Last Update Date2015-06-20
Business Address
-- JACKIE TA D.O
1653 W CONGRESS PKWY
CHICAGO, IL 60612-3833
Phone number: 703-342-9546
Mailing Address
-- JACKIE TA D.O
1653 W CONGRESS PKWY
CHICAGO, IL 60612-3833
Phone number: 703-342-9546
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