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Organization
ANNITA JOHN M.D. P.C.
Active
Organization
ANNITA JOHN M.D. P.C.
Active
Other names
Heritage Medical
Organization subpart
No
Provider details
NPI number
Authorized official
ANNITA JOHN M.D. (PHYSICIAN)
(773) 238-1616
Entity
Organization
Contact information
Practice address
10237 S WESTERN AVE, CHICAGO, IL 60643-1917
(773) 238-1616
(773) 238-2660
Mailing address
10237 S WESTERN AVE, CHICAGO, IL 60643-1917
(773) 238-1616
(773) 238-2660
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0161873463
BCBS
IL
Enumeration date
06/11/2007
Last updated
05/05/2010
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