JONATHAN BACOS

CHICAGO, IL
NPI1265987440
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL  B22043894236)
Enumeration Date2016-08-17
Last Update Date2020-03-25
Business Address
JONATHAN BACOS student
240 E HURON ST SUITE 1-200
CHICAGO, IL 60611-2909
Phone number: 312-503-7975
Mailing Address
JONATHAN BACOS student
8701 W WATERTOWN PLANK RD
MILWAUKEE, WI 53226-3548
Phone number: 414-955-4578