Individual
JONATHAN D POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1051 W RAND RD STE 103, ARLINGTON HEIGHTS, IL 60004-2315
(847) 259-5900
Mailing address
1450 BUSCH PKWY STE 130, BUFFALO GROVE, IL 60089-4541
(847) 499-3070
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036109242
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109242
—
IL
Enumeration date
01/05/2006
Last updated
12/21/2021
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