SearchIllinois1041C0700X

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