Johnny Contreras
Physician Assistant in Oak Lawn, IL. Individual provider (NPI-1).
NPI number1982175691
StatusActive
Last updated in NPPESJun 6, 2022
Details
- NPI
- 1982175691
- Entity type
- Individual (NPI-1)
- Name
- Johnny Contreras
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 7, 2018
- Certification date
- Jun 6, 2022
- Last updated
- Jun 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085-007061 | IL | Yes |
Practice location
4440 W 95th St Ste 1332hOak Lawn, IL 60453-2600
Phone 708-684-2016
Mailing address
29373 Network PlChicago, IL 60673-1293
Phone 847-390-5900
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