Individual
GIANNA MARIE PRUCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
963 N 129TH INFANTRY DR, JOLIET, IL 60435-3104
(877) 632-6637
(708) 409-5179
Mailing address
963 N 129TH INFANTRY DR, JOLIET, IL 60435-3104
(877) 632-6637
(708) 409-5179
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085010068
IL
363A00000X
Physician Assistant
10004588A
IN
Other
Enumeration date
08/16/2023
Last updated
10/28/2024
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