Individual
STEPHANIE LASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.M.S,, PA-C
Contact information
Practice address
5744 N BROADWAY ST, CHICAGO, IL 60660-4302
(312) 335-0180
(773) 275-4679
Mailing address
5744 N BROADWAY ST, CHICAGO, IL 60660-4302
(312) 335-0180
(773) 275-4679
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004878
IL
Other
Enumeration date
11/26/2013
Last updated
11/26/2013
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