Provider Demographics
NPI:1619745619
Name:THROW, JESSE THOMAS (DC)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:THOMAS
Last Name:THROW
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 N MILL ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1275
Mailing Address - Country:US
Mailing Address - Phone:630-791-0058
Mailing Address - Fax:
Practice Address - Street 1:1805 N MILL ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1275
Practice Address - Country:US
Practice Address - Phone:630-791-0058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program