Individual
JOHN LOUIS ANCONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4400 W 95TH ST, SUITE 205, OAK LAWN, IL 60453-2654
(630) 977-9764
(708) 346-3287
Mailing address
4400 W 95TH ST, SUITE 205, OAK LAWN, IL 60453-2654
(630) 977-9764
(708) 346-3287
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000886
IL
Other
Enumeration date
12/07/2005
Last updated
08/19/2015
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