Individual
JOSEPH KIZHAKKADATHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
757 PARK AVE W, HIGHLAND PARK, IL 60035-2556
(847) 570-1700
Mailing address
757 PARK AVE W, HIGHLAND PARK, IL 60035-2556
(847) 570-1700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
085009965
IL
Other
Enumeration date
05/15/2023
Last updated
09/07/2023
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