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Individual

JONATHAN PAUL P. BARBOSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
377 W VIRGINIA ST, CRYSTAL LAKE, IL 60014-5756
(815) 707-4806
Mailing address
502 MCHENRY AVE APT 103, WOODSTOCK, IL 60098-2975
(815) 707-4806

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IL

Other

Enumeration date
02/19/2026
Last updated
02/19/2026
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