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Individual

DR. ASHISH MANI ANSAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2045 W. WASHINGTON BLVD, CHICAGO, IL 60612-2428
(312) 996-2000
(312) 413-7812
Mailing address
2045 W. WASHINGTON BLVD, CHICAGO, IL 60612-2428
(312) 996-2000
(312) 413-7812

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.130215
IL
390200000X
Student in an Organized Health Care Education/Training Program
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036.130215
IL
Enumeration date
04/24/2009
Last updated
10/12/2012
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