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Individual

MR. CONNER THOMAS LIVINGSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3311 N HALSTED ST, CHICAGO, IL 60657-2412
(773) 435-9994
Mailing address
4755 N MALDEN ST APT GS, CHICAGO, IL 60640-4386

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.010583
IL
363A00000X
Physician Assistant

Other

Enumeration date
08/19/2024
Last updated
10/11/2024
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