MARK SONG

EVANSTON, IL
NPI1700345659
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085007006)
Enumeration Date2019-03-19
Last Update Date2021-09-07
Business Address
MARK SONG PA-C
2650 RIDGE AVE BURCH 221
EVANSTON, IL 60201
Phone number: 847-570-1440
Mailing Address
MARK SONG PA-C
2650 RIDGE AVE BURCH 221
EVANSTON, IL 60201-1718
Phone number: 847-570-1440