Individual
ASHWIN LUIS DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS, MS, MRCSED, DN
Contact information
Practice address
1760 W. TAYLOR STREET, UNIVERSITY OF ILLINOIS, CHICAGO, IL 60612
(866) 600-2273
Mailing address
1926 W. HARRISON STREET, APARTMENT 506, CHICAGO, IL 60612
(312) 752-7106
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125055569
IL
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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