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Individual

JONATHAN LARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
812 ASTER CT, NORTH AURORA, IL 60542-8909
(870) 331-0170
Mailing address
812 ASTER CT, NORTH AURORA, IL 60542-8909
(870) 331-0170

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043124100
IL

Other

Enumeration date
10/17/2025
Last updated
10/17/2025
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