Individual
ALEXANDER JONATHAN PETTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 E CHICAGO AVE, CHICAGO, IL 60611-4296
(312) 503-8144
Mailing address
77 W HURON ST APT 613, CHICAGO, IL 60654-3888
(405) 308-5213
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
125.087514
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OK
Other
Enumeration date
08/19/2022
Last updated
06/09/2026
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