Individual
ETHAN DENNIS DAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
306 WASHINGTON ST, INGLESIDE, IL 60041-8324
(847) 587-3312
Mailing address
306 WASHINGTON ST, INGLESIDE, IL 60041-8324
(847) 587-3312
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
060783107
IL
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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