Individual
DR. JONATHAN B VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-2966
Mailing address
1033 WESTMORE MEYERS RD, APT. 110, LOMBARD, IL 60148-3285
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
IL
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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