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Individual

JOSE MAGANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-4700
Mailing address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-4700

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-099806
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036099806
MEDICAID
IL
05
036099806
IL
01
920540
MEDICARE PTAN (GROUP)
IL
01
F400191302
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
08/10/2006
Last updated
03/25/2015
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