Jonathan Joseph Vitale D.O.

NPI 1639461411 - Family Medicine - 207Q00000X

NPI Details
NPI 1639461411
Gender Male
Enumeration Date 05/11/2011
Last Updated 08/05/2014
Entity Type Individual
Active Over 5 years ago
Practice Location
1130 W CORNELIA AVE
UNIT D
CHICAGO IL, 60657-1549, US
Phone (315) 664-6664
Fax
Business Location
1130 W CORNELIA AVE
UNIT D
CHICAGO IL, 60657-1549, US
Phone (315) 664-6664
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Illinois
License Number 036133910
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According to our database, Dr. Jonathan Joseph Vitale D.O. NPI is 1639461411, taxonomy code is 207Q00000X and license number is 036133910, license state is located at Illinois. Jonathan Joseph Vitale D.O. physically located at 1130 W Cornelia Ave, Chicago IL, 60657-1549. NPI Number Jonathan Joseph Vitale D.O. has the Individual type.

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1639461411 NPI number is provided on an as is basis without warranty of any kind. 1639461411 is maintained by the National Plan & Provider Enumeration System. The contents of Jonathan Joseph Vitale D.O. are for informational purposes only.