Individual
JERRYL JOHNSON SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2012 S AUSTRIAN PINE ST, LOCKPORT, IL 60441-3876
(708) 712-3802
Mailing address
9119S EXCHANGE AVE, CHICAGO, IL 60617-4225
(773) 768-5000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036070465
IL
Other
Enumeration date
04/23/2008
Last updated
12/18/2015
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