Individual
MIRZA R BAIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1519 W GRANVILLE AVE, APT 1B, CHICAGO, IL 60660-1811
(773) 690-2589
Mailing address
1519 W GRANVILLE AVE, APT 1B, CHICAGO, IL 60660-1811
(773) 690-2589
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
B20055679313
IL
Other
Enumeration date
01/06/2014
Last updated
01/06/2014
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