Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 036.143200 | IL |
Y | 207RC0200X | Critical Care Medicine | 036.143200 | IL |
NPI | 1063772572 |
---|---|
Provider Name | Emily Katherine Jonas |
First Address | Oak Lawn, IL 60453 |
Second Address | Oak Lawn, IL 60453-2600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2012 |
Last Update Date | 09/05/2018 |