Individual
JOHN NICHOLAS LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(312) 864-3825
Mailing address
633 S LAFLIN ST, APT 2, CHICAGO, IL 60607-3177
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
IL
Other
Enumeration date
08/02/2006
Last updated
07/08/2007
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