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Individual
JOHN JAHNKE
Active
Individual
JOHN JAHNKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1066142
IL
363A00000X
Physician Assistant
Primary
2470
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
570769093
—
SC
Enumeration date
10/28/2005
Last updated
10/24/2018
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