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1740436781
JUSTIN RAY BLACK
CHICAGO, IL
NPI
1740436781
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207L00000X Anesthesiology
(Licence: IL 036-121182)
Enumeration Date
2008-08-11
Last Update Date
2008-08-11
Business Address
-- JUSTIN RAY BLACK M.D.
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637-1447
Phone number: 773-702-6700
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Mailing Address
-- JUSTIN RAY BLACK M.D.
3546 WILLOW ST
FLOSSMOOR, IL 60422-2243
Phone number: 708-922-9299
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