Individual
ANDREW SUPLICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
635 N DEARBORN ST, CHICAGO, IL 60654-4618
(312) 694-2273
Mailing address
635 N DEARBORN ST STE 100, CHICAGO, IL 60654-4618
(312) 694-2273
(312) 694-2129
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007895
IL
Other
Enumeration date
03/19/2020
Last updated
01/06/2021
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