Jonathan Aniciete, DO
Family Medicine in Berwyn, IL. Individual provider (NPI-1).
NPI number1043012016
StatusActive
Last updated in NPPESMay 16, 2025
Details
- NPI
- 1043012016
- Entity type
- Individual (NPI-1)
- Name
- Jonathan Aniciete
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2025
- Certification date
- May 16, 2025
- Last updated
- May 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 125.085802 | IL | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
3249 Oak Park AveBerwyn, IL 60402-0715
Phone 708-783-3094
Mailing address
3249 Oak Park AveBerwyn, IL 60402-3429
Phone 708-783-2000
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