Individual provider · NPI-1

Dr. Sargon Audisho

Preventive Medicine, Public Health & General Preventive Medicine · Chicago, IL

NPI number1568690899
StatusActive
Last updated in NPPESJul 18, 2013

Details

NPI
1568690899
Entity type
Individual (NPI-1)
Name
Dr. Sargon Audisho
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 25, 2009
Last updated
Jul 18, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine036132241ILYes

Practice location

4143 N Claremont Ave
Apt 2
Chicago, IL 60618-2919

Phone 312-218-1204

Mailing address

890 E Higgins Rd
Suite 113a
Schaumburg, IL 60173-4799

Phone 224-653-9000

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