Individual
JERICHO HALLARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2160 S. 1ST. AVENUE BLDG. 105, SUITE 2840A, MAYWOOD, IL 60153
(888) 584-7888
Mailing address
2160 S. 1ST. AVENUE BLDG. 105, SUITE 2840A, MAYWOOD, IL 60153
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125081474
IL
Other
Enumeration date
03/21/2023
Last updated
05/01/2023
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