Individual
DR. JONATHAN T NASSOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6374 N LINCOLN AVE, SUITE 301, CHICAGO, IL 60659-1275
(773) 463-2377
Mailing address
6374 N LINCOLN AVE, SUITE 301, CHICAGO, IL 60659-1275
(773) 463-2377
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036114903
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232584
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/08/2008
Last updated
10/23/2008
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