Organization
ANNITA JOHN M.D. P.C.
Active
Other names
Heritage Medical
Organization subpart
No
Provider details
NPI number
Authorized official
ANNITA JOHN M.D. (PHYSICIAN)
(773) 238-1616
Entity
Organization
Contact information
Practice address
10237 S WESTERN AVE, CHICAGO, IL 60643-1917
(773) 238-1616
(773) 238-2660
Mailing address
10237 S WESTERN AVE, CHICAGO, IL 60643-1917
(773) 238-1616
(773) 238-2660
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0161873463
BCBS
IL
Enumeration date
06/11/2007
Last updated
05/05/2010
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