Individual
MR. DEON EDWARD GRIFFIN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EIN
Contact information
Practice address
602 VIRGINIA AVE, LYNWOOD, IL 60411-4643
(773) 240-6594
Mailing address
602 VIRGINIA AVE, LYNWOOD, IL 60411-4643
(773) 240-6594
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
343900000X
IL
Other
Enumeration date
10/08/2025
Last updated
10/08/2025
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