Individual
ISMENE POTAKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
675 N SAINT CLAIR ST STE 14-200, CHICAGO, IL 60611-5966
(126) 957-5423
(312) 695-5462
Mailing address
675 N SAINT CLAIR ST STE 14-200, CHICAGO, IL 60611-5966
(312) 695-7542
(126) 955-4623
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004104
IL
Other
Enumeration date
08/23/2011
Last updated
08/24/2021
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