Mark Ambrose, PA-C
NPI #1043424740 in Hazel Crest, Illinois
Provider Information
- NPI Number
- 1043424740
- Entity Type
- Individual
- Name
- Mark Ambrose, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- May 10, 2007
- Last Updated
- May 13, 2016
Practice Location
- Address
- 3330 W 177TH ST
- Address 2
- SUITE 3E
- City
- Hazel Crest
- State
- Illinois
- ZIP Code
- 60429-2184
- Phone
- (708) 206-0010
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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