Individual
EZRA HUNTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4009 N BROADWAY ST, CHICAGO, IL 60613-2110
(773) 275-2586
Mailing address
4009 N BROADWAY ST, CHICAGO, IL 60613-2110
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.007818
IL
363AM0700X
Medical Physician Assistant
085007818
IL
Other
Enumeration date
04/07/2020
Last updated
09/27/2024
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