JEREMY A HOUTAKKER

CRYSTAL LAKE, IL
NPI1902092109
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant Surgical
Enumeration Date2007-09-20
Last Update Date2007-09-20
Business Address
MR. JEREMY A HOUTAKKER P.A.
750 E TERRA COTTA AVE SUITE C
CRYSTAL LAKE, IL 60014-3621
Phone number: 815-455-0800
Mailing Address
MR. JEREMY A HOUTAKKER P.A.
750 E TERRA COTTA AVE SUITE C
CRYSTAL LAKE, IL 60014-3621
Phone number: 815-455-0800