Individual
JUAN NOGUERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RSA
Contact information
Practice address
19015 S JODI RD, MOKENA, IL 60448-8514
(708) 995-5418
Mailing address
19015 S JODI RD, MOKENA, IL 60448-8514
(708) 995-5418
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
238000836
IL
363AS0400X
Surgical Physician Assistant
Primary
238000836
IL
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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