Individual
ERDAN KAYUPOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
5616 FAWN CT, TROY, MI 48098-2549
(248) 635-6387
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/25/2016
Last updated
12/07/2022
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