MARK AMBROSE, PA-C
Physician Assistant
Active
Individual
NPI: 1043424740
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant | 363A00000X | Yes | 085000830 (IL) |
Frequently Asked Questions
NPI 1043424740 is the National Provider Identifier for MARK AMBROSE, PA-C, a Physician Assistant provider located in Hazel Crest, IL. This NPI was enumerated on May 10, 2007.
MARK AMBROSE, PA-C practices at 3330 W 177TH ST, SUITE 3E, Hazel Crest, IL 60429.
Quick Facts
- NPI
- 1043424740
- Type
- Individual
- Enumerated
- May 10, 2007
- Last Updated
- May 13, 2016
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