Individual
MR. BRADLY WINSTON CHIKARA WATARAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
355 RIDGE AVE, EVANSTON, IL 60202-3399
(847) 316-4000
Mailing address
355 RIDGE AVE, EVANSTON, IL 60202
(808) 371-9889
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
04/25/2024
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