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General NPI Number Information
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NPI Number | 1790804136
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Entity Type | Individual
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Provider Name | JOHN STEVEN STRACKS MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 1828 W WEBSTER AVE STE 450
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City | CHICAGO
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State | IL
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Zip | 60614-2916
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Country | US
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Telephone | 312-489-8890
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Fax | 773-337-7316
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Provider Business Mailing Address
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Address Line | 1828 W WEBSTER AVE STE 450
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City | CHICAGO
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State | IL
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Zip | 60614-2916
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Country | US
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Telephone | 312-489-8890
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Fax | 773-337-7316
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301085634
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036123810
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License Number State | IL
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