Individual
JOSE R FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5637 NORTH COURTLAND AVE, CHICAGO, IL 60631-2907
(847) 292-1489
(847) 292-1489
Mailing address
5637 NORTH COURTLAND AVE, CHICAGO, IL 60631-2907
(847) 292-1489
(847) 292-1489
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036060326
IL
Other
Enumeration date
05/11/2012
Last updated
05/11/2012
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