Individual
JONATHAN SONTAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1525 N VETERANS PKWY, BLOOMINGTON, IL 61704-0904
(309) 661-8613
Mailing address
1525 N VETERANS PKWY, BLOOMINGTON, IL 61704-0904
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051302888
IL
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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