ALEC SAMUEL SMALL

KENOSHA, WI
NPI1700464526
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: WI  81508-21)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: IL  036.166609)
Enumeration Date2021-04-01
Last Update Date2024-09-17
Business Address
ALEC SAMUEL SMALL DO
10400 75TH ST
KENOSHA, WI 53142-7884
Phone number: 262-948-5600
Mailing Address
ALEC SAMUEL SMALL DO
808 S WOOD ST RM 469A
CHICAGO, IL 60612-7300
Phone number: