Organization
JOHN C TRICOU MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C TRICOU M.D (PRESIDENT)
(708) 460-7444
Entity
Organization
Contact information
Practice address
200 E FAIRMAN AVE, WATSEKA, IL 60970-1644
(815) 432-5841
Mailing address
9410 COMPUBILL DR, ORLAND PARK, IL 60462-2627
(708) 460-7444
(708) 460-8662
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
036078029
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036078029
IL
2085U0001X
Diagnostic Ultrasound Physician
036078029
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078029
—
IL
Enumeration date
08/19/2009
Last updated
03/27/2013
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