Individual
JEHOVANY EDWARD GRATIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 S PAULINA ST STE 403, CHICAGO, IL 60612-3806
(312) 942-7100
Mailing address
600 S PAULINA ST STE 403, CHICAGO, IL 60612-3806
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.083005
IL
Other
Enumeration date
06/09/2023
Last updated
07/04/2023
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