Individual
MICHAEL UBAGHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
555 S SCHUYLER AVE STE 235, KANKAKEE, IL 60901-5178
(312) 405-5670
(219) 306-8090
Mailing address
555 S SCHUYLER AVE STE 235, KANKAKEE, IL 60901-5178
(815) 401-6666
(815) 614-3363
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
U12654362296
IL
Other
Enumeration date
10/01/2014
Last updated
12/13/2021
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