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Individual

MICHAEL PENDERGAST JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
9701 W HIGGINS RD STE 270, ROSEMONT, IL 60018-4703
(847) 692-3715
(815) 986-4218
Mailing address
1010 CURTISS ST APT B1, DOWNERS GROVE, IL 60515-4518
(309) 331-3448

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006827
IL
363A00000X
Physician Assistant

Other

Enumeration date
10/25/2018
Last updated
10/20/2021
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