Individual
MR. JAKE WASHKOWIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2152 LAHARPE ST, LA SALLE, IL 61301-1452
(815) 326-2170
Mailing address
2152 LAHARPE ST, LA SALLE, IL 61301-1452
(815) 326-2170
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/26/2017
Last updated
04/26/2017
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