Individual
TOM AARON INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1653 W CONGRESS PKWY # 12, CHICAGO, IL 60612-3833
(706) 580-0650
Mailing address
221 W HUBBARD ST UNIT 1708, CHICAGO, IL 60654-4920
(706) 580-0650
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
1-174846
AL
367500000X
Certified Registered Nurse Anesthetist
209030865
IL
Other
Enumeration date
07/26/2023
Last updated
10/28/2024
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