Individual
MICAH ZEB ELLOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-5522
Mailing address
307 BENEDICT RD, EL PASO, TX 79922-1205
(915) 920-3421
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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