Individual
JANTINA R VONK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
625 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 280-2510
(608) 280-2426
Mailing address
1425 RED CLOUD LANE, MADISON, WI 53704
(608) 245-1665
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
34728
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31970500
—
WI
Enumeration date
05/17/2006
Last updated
07/08/2007
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