Individual
AI-XUAN L HOLTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1725 W HARRISON ST, SUITE 818, CHICAGO, IL 60612-3841
(312) 942-5397
Mailing address
3926 NEW VISION DR, BLDG H, FORT WAYNE, IN 46845-1712
(260) 266-8213
(260) 458-5658
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
01057253
IN
Other
Enumeration date
05/05/2006
Last updated
01/18/2017
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