NPI 1003891649

John Louis Ancona, PA

Practitioner Physician Assistant Oak Lawn, IL

Practice location

Address: 4400 W 95th St Suite 205, Oak Lawn, IL 60453-2654
Phone: (630) 977-9764
Fax: (708) 346-3287

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 085000886 (IL)

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Registry record

NPI: 1003891649
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Dec 2005
Record last updated: 19 Aug 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.