Individual
LAITH SOROUR AHMAD SOROUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
355 RIDGE AVE, EVANSTON, IL 60202-3399
(224) 529-8747
Mailing address
911 ELMWOOD AVE APT G3, EVANSTON, IL 60202-1758
(224) 529-8747
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
125.082025
IL
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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