Individual
EMMA RAIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 N ASHLAND AVE, CHICAGO, IL 60614-2021
(773) 270-5600
Mailing address
1025 W WEBSTER AVE UNIT 3, CHICAGO, IL 60614-7422
(847) 739-6406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.007318
IL
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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