Individual
PAUL E WEST III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1900 W POLK ST, CHICAGO, IL 60612-3723
(312) 864-0917
(312) 864-9242
Mailing address
527 ABERDEEN RD, FRANKFORT, IL 60423-9712
(815) 806-0340
(815) 806-0341
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
10000855A
IN
363AS0400X
Surgical Physician Assistant
Primary
085-000949
IL
363AS0400X
Surgical Physician Assistant
10000855A
IN
Other
Enumeration date
08/09/2006
Last updated
07/26/2012
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