Individual
JONATHAN RUSSELL THOMULKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5145 N CALIFORNIA AVE, CHICAGO, IL 60625-3661
(773) 878-8200
Mailing address
1800 N WOOD ST, CHICAGO, IL 60622-1129
(818) 424-5706
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.071515
IL
Other
Enumeration date
06/29/2017
Last updated
03/31/2021
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