Individual
DR. JUAN C. JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 N WALL ST, SUITE 402, KANKAKEE, IL 60901-2940
(815) 932-7200
(815) 935-7874
Mailing address
400 N WALL ST, SUITE 402, KANKAKEE, IL 60901-2940
(815) 932-7200
(815) 935-7874
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036103254
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36103254
—
IL
01
—
4632039
BC GROUP NUMBER
IL
Enumeration date
09/16/2006
Last updated
03/22/2021
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