Individual
DR. JEREMY CHARLES CURTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1775 W DEMPSTER ST, PARK RIDGE, IL 60068-1143
(123) 456-7890
Mailing address
4724 N BERNARD ST, APT 2E, CHICAGO, IL 60625-5341
(312) 285-9990
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
125.059157
IL
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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