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Individual

MRS. GRISELDA HERNANDEZ RAHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1111 SUPERIOR ST, SUITE 302, MELROSE PARK, IL 60160-4138
(708) 344-0808
(708) 344-5055
Mailing address
6065 S 76TH AVE, SUMMIT, IL 60501-1533
(708) 496-0351

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
85002784
IL

Other

Enumeration date
01/31/2007
Last updated
07/08/2007
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