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Individual

TRISTAYN MCKEE OWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2150 W HARRISON ST, CHICAGO, IL 60612-3706
(312) 942-5375
Mailing address
2150 W HARRISON ST, CHICAGO, IL 60612-3706

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
125.083888
IL
390200000X
Student in an Organized Health Care Education/Training Program
125083888
IL

Other

Enumeration date
06/12/2024
Last updated
08/05/2024
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