Individual
DR. JONATHAN ALCANTAR-HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1853 W POLK ST RM 105C, CHICAGO, IL 60612-4355
(312) 996-8228
Mailing address
727 S LAFLIN ST APT 2S, CHICAGO, IL 60607-3122
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/24/2021
Last updated
05/24/2021
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