Individual
JON PASCUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3204
(847) 990-2165
(847) 362-8031
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-084079
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-084079
—
IL
01
—
L31070
MEDICARE PIN FOR #645650
IL
Enumeration date
06/12/2006
Last updated
09/26/2022
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