Individual
DR. JOBIN KOSHY JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 W TAYLOR ST, CHICAGO, IL 60612-4795
(312) 996-3253
Mailing address
1209 N OAK PARK AVE, OAK PARK, IL 60302-1254
(312) 953-1086
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036130077
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036130077
—
IL
Enumeration date
11/12/2009
Last updated
07/21/2022
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