Provider Demographics
NPI:1548309982
Name:PARKER, JONATHAN CHARLES JR (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:CHARLES
Last Name:PARKER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 N RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-1992
Mailing Address - Country:US
Mailing Address - Phone:630-482-6600
Mailing Address - Fax:
Practice Address - Street 1:815 N RANDALL RD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-1992
Practice Address - Country:US
Practice Address - Phone:630-482-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01082742A207Q00000X
IL36069180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine