Individual
KIMBERLY BROOKE GOLISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(312) 926-2000
Mailing address
3724 E MAFFEO RD, PHOENIX, AZ 85050-8341
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125.074327
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/17/2019
Last updated
06/19/2019
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