Individual
ASHLEY LA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5841 S MARYLAND AVE STE MC5100, CHICAGO, IL 60637-1443
(773) 702-3630
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.163457
IL
207RN0300X
Nephrology Physician
Primary
036.163457
IL
Other
Enumeration date
04/18/2020
Last updated
07/17/2024
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