Individual
JARMO J ITKONEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
71 W 156TH ST, SUITE 203, HARVEY, IL 60426-4260
(708) 331-0408
(708) 331-8164
Mailing address
18141 DIXIE HWY, SUITE 107, HOMEWOOD, IL 60430-2238
(708) 799-8440
(708) 799-8446
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036060989
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036060989
—
IL
01
—
290001113A
RR MEDICARE
—
01
—
31601092
BLUE SHIELD
IL
Enumeration date
12/16/2005
Last updated
09/18/2014
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