Individual
ETHAN HIXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
250 E SUPERIOR ST, PRENTICE, 4-420, CHICAGO, IL 60611-2914
(312) 472-0440
(312) 472-4781
Mailing address
250 E SUPERIOR ST, PRENTICE, 4-420, CHICAGO, IL 60611-2914
(312) 472-0440
(312) 472-4781
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
IL
Other
Enumeration date
01/03/2007
Last updated
03/06/2008
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