Individual
DR. JEROME ANTONY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
327 W 76TH ST, CHICAGO, IL 60620-1604
(773) 224-6837
(773) 224-6841
Mailing address
327 W 76TH ST, CHICAGO, IL 60620-1604
(773) 224-6837
(773) 224-6841
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036062248
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036062248
—
IL
Enumeration date
05/19/2006
Last updated
06/18/2008
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