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Individual

HANNA MARIE KINGSTAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2650 RIDGE AVE., WALGREEN 3507, EVANSTON, IL 60201-1718
(847) 570-2827
(847) 733-5005
Mailing address
2650 RIDGE AVE., WALGREEN 3507, EVANSTON, IL 60201-1718
(847) 570-2827
(847) 733-5005

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085010156
IL

Other

Enumeration date
07/13/2022
Last updated
02/06/2024
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