Individual
PATRICK JOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 S MAPLE AVE, OAK PARK, IL 60304-1022
(312) 942-6504
Mailing address
1653 W. CONGRESS PARKWAY, 735 JELKE, ANESTHESIA DEPT, CHICAGO, IL 60612
(312) 942-6504
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209005888
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN9319858
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209005888
—
IL
Enumeration date
06/20/2006
Last updated
11/17/2021
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