Jonathan Bacos, STUDENT
Jonathan Bacos, STUDENT 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
- 2016
Practice location Address checks out
240 E Huron St Ste 1-200Chicago, IL 60611-2909
Phone: (312) 503-7975
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X · Licence B22043894236 (IL) |
|---|
Record details
| NPI number | 1265987440 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | STUDENT |
| Sole proprietor | Yes |
| NPI enumerated | August 17, 2016 |
| Last updated in NPPES | March 25, 2020 |
| Certification date | March 25, 2020 |
| Mailing address | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 |
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