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1902092109
JEREMY A HOUTAKKER
CRYSTAL LAKE, IL
NPI
1902092109
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: IL 085003045)
Enumeration Date
2007-09-20
Last Update Date
2007-09-20
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
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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
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