Individual
SPENCER MOSSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 S PAULINA ST STE 403, CHICAGO, IL 60612-3806
(312) 942-7100
Mailing address
600 S PAULINA ST STE 403, CHICAGO, IL 60612-3806
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
1265061980
IL
Other
Enumeration date
04/04/2020
Last updated
06/07/2021
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