Individual
SOURABH NAGALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
2515 N CLARK ST, STE 802, CHICAGO, IL 60614
(312) 227-6210
(312) 227-9429
Mailing address
2515 N CLARK ST, STE 802, CHICAGO, IL 60614
(312) 227-6210
(312) 227-9429
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
213000186
IL
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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