Individual
DR. JONATHON WILLIAM WANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(630) 915-4834
Mailing address
2650 RIDGE AVE., DEPARTMENT OF PSYCHIATRY, EVANSTON, IL 60201-1718
(847) 570-2540
(847) 570-2939
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036155918
IL
Other
Enumeration date
03/23/2018
Last updated
01/20/2023
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