Individual
DR. JOHN-LUKE RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-3250
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-3250
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
125.080873
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2022
Last updated
06/15/2022
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