Individual
JACK DENNIS ZANDSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
40 75TH ST, WILLOWBROOK, IL 60527-2325
(630) 581-5372
Mailing address
40 75TH ST, WILLOWBROOK, IL 60527-2325
(630) 581-5372
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1171553
IL
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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