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General NPI Number Information
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NPI Number | 1225231707
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Entity Type | Organization
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Legal Business Name | ANNITA JOHN M.D. P.C.
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 10237 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643-1917
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Country | US
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Telephone | 773-238-1616
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Fax | 773-238-2660
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Provider Business Mailing Address
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Address Line | 10237 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643-1917
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Country | US
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Telephone | 773-238-1616
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Fax | 773-238-2660
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ANNITA JOHN
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Credential | M.D.
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Telephone | 773-238-1616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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