Individual provider · Type 1 NPI

Jonathan Bacos, STUDENT

Student in an Organized Health Care Education/Training Program · Chicago, IL

NPI number 1265987440 Active

Practice location

240 E Huron St, Suite 1-200
Chicago, IL 60611-2909

Call (312) 503-7975 Map

Mailing address

8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XB22043894236 (IL)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1265987440

Jonathan Bacos, STUDENT's National Provider Identifier is 1265987440, issued on Aug 17, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Chicago, IL. The record was last updated on Mar 25, 2020.