Individual
JONATHAN ERICSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3901 RAINBOW BLVD # MS 4034, KANSAS CITY, KS 66160-8500
(913) 588-1908
(913) 588-8387
Mailing address
1950 HARLEM AVE, NORTH RIVERSIDE, IL 60546-1470
(708) 354-9250
(708) 354-8765
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036169823
IL
Other
Enumeration date
03/31/2020
Last updated
01/06/2025
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