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1851973721
LARISSA FOMUM MUGRI
CHICAGO, IL
NPI
1851973721
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-04-21
Last Update Date
2021-04-21
Business Address
LARISSA FOMUM MUGRI MD
5841 S MARYLAND AVE # MC5068
CHICAGO, IL 60637-1443
Phone number: 773-702-9109
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Mailing Address
LARISSA FOMUM MUGRI MD
180 HARVESTER DR STE 110
BURR RIDGE, IL 60527-6686
Phone number: 773-702-1150
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