Individual
ARIELLE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2800 S CALIFORNIA AVE, CHICAGO, IL 60608-5107
(773) 764-7488
Mailing address
2800 S CALIFORNIA AVE, CHICAGO, IL 60608-5107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006499
IL
363A00000X
Physician Assistant
PA11748
TX
Other
Enumeration date
02/26/2018
Last updated
04/23/2021
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