Individual
MR. JUSTIN MICHAEL VODA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, BSN
Contact information
Practice address
1620 W HARRISON ST, CHICAGO, IL 60612-3801
(312) 352-7874
Mailing address
607 PALACE ST, AURORA, IL 60506-3017
(630) 270-8157
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041426795
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209.031205
IL
Other
Enumeration date
07/24/2023
Last updated
02/24/2025
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