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1366444184
JACK C. ENTER
CHICAGO, IL
NPI
1366444184
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085-000925)
Enumeration Date
2005-08-11
Last Update Date
2008-10-17
Business Address
-- JACK C. ENTER PA-C
4211 N CICERO AVE SUITE 100
CHICAGO, IL 60641-1651
Phone number: 773-794-1000
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Mailing Address
-- JACK C. ENTER PA-C
10100 FOREST HILLS RD
MACHESNEY PARK, IL 61115-8234
Phone number: 815-713-2742
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