Individual
MANSOOREH EGHTESAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
303 E CHICAGO AVE, CHICAGO, IL 60611-4296
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036137150
IL
Other
Enumeration date
04/08/2011
Last updated
01/18/2022
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