Individual
JONATHAN NITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
624 NE GLEN OAK AVE, ROOM 2670, PEORIA, IL 61603-3135
(309) 655-3971
Mailing address
2110 W GENEVA RD, PEORIA, IL 61615-6204
(502) 320-4248
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125.069354
IL
Other
Enumeration date
06/27/2016
Last updated
06/27/2016
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