Individual
JOHN THOMAS BALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
836 W WELLINGTON AVE BOX 19, CHICAGO, IL 60657-5147
(773) 296-3003
(773) 296-3002
Mailing address
836 WEST WELLINGTON BOX 19, CHICAGO, IL 60657-5147
(773) 296-3003
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036060468
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036060468
—
IL
01
—
31600038
BLUE SHIELD
IL
Enumeration date
11/01/2006
Last updated
02/17/2017
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