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Ontonio Jackson-Lucas
NPI 1538946702 · on the registry since 2023
Practice
- Address
- 626 E Glenwood Dyer Rd
Glenwood, IL 60425 - Phone
- (708) 983-9044
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-09-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois