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Individual

DR. JONATHAN CHARLES RENKAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9111 S DOBSON AVE, CHICAGO, IL 60619-7817
(312) 204-9131
Mailing address
9111 S DOBSON AVE, CHICAGO, IL 60619-7817
(312) 204-9131

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01064325A
IN
207P00000X
Emergency Medicine Physician
036-098742
IL
207P00000X
Emergency Medicine Physician
Primary
38098-020
WI
207P00000X
Emergency Medicine Physician
38098-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1972643948
WI
Enumeration date
02/07/2007
Last updated
12/02/2020
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