Individual
JEAN HOULIHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
430 WARRENVILLE RD, WARRENVILLE, IL 60532
(630) 432-6180
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-0018
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036085979
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085979
—
IL
01
—
P00736418
RR MEDICARE
IL
Enumeration date
10/05/2005
Last updated
06/14/2022
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