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1700345659
MARK SONG
EVANSTON, IL
NPI
1700345659
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085007006)
Enumeration Date
2019-03-19
Last Update Date
2021-09-07
Business Address
MARK SONG PA-C
2650 RIDGE AVE BURCH 221
EVANSTON, IL 60201
Phone number: 847-570-1440
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Mailing Address
MARK SONG PA-C
2650 RIDGE AVE BURCH 221
EVANSTON, IL 60201-1718
Phone number: 847-570-1440
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