Maxwell Ethan Edmonds
Maxwell Ethan Edmonds is a Student in an Organized Health Care Education/Training Program in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois.
- Licensed in
- IL
- In the registry since
- 2015
Practice location Address checks out
3324 N Clifton Ave Apt 2FChicago, IL 60657-2285
Phone: (401) 480-1194
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X (IL) |
|---|
Record details
| NPI number | 1306238142 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | March 3, 2015 |
| Last updated in NPPES | June 5, 2022 |
| Certification date | June 5, 2022 |
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