Individual
RAY BASA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA
Contact information
Practice address
9600 GROSS POINT RD, SKOKIE, IL 60076-1214
(773) 404-0160
Mailing address
9600 GROSS POINT RD, SKOKIE, IL 60076-1214
(773) 404-0160
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
IL
Other
Enumeration date
02/20/2008
Last updated
02/20/2008
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