JEREMY A HOUTAKKER, PA, Surgical CRYSTAL LAKE, IL

Contact Information

JEREMY A HOUTAKKER, PA

750 E TERRA COTTA AVE
SUITE C
CRYSTAL LAKE, IL 60014-3621

Phone: 815-455-0800
Fax: 815-455-2895
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Surgical	363AS0400X	97	Physician Assistant

Indicates primary specialty

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NPI Profile & details for JEREMY A HOUTAKKER · (Male)

NPI #	`1902092109`
Status	Active
Credentials	PA (Physician Assistant)
Entity	Individual
Enumeration date	09/20/2007
Last updated	09/20/2007 - About 19 years ago
Sole proprietor ¹	No
Identifiers	Not Available
Hospital affiliation(s)	MERCY HARVARD HOSPITAL - (Critical Access) 901 GRANT STREET HARVARD, IL 60033 MERCY HEALTH SYS CORP - (Acute Care) 1000 MINERAL POINT AVE JANESVILLE, WI 53548 MERCY WALWORTH HOSPITAL & MEDICAL CENTER - (Critical Access) N2950 STATE ROAD 67 LAKE GENEVA, WI 53147

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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JEREMY A HOUTAKKER, PA – NPI #1902092109Surgical

Contact Information

Specialty

Surgical

NPI Profile & details for JEREMY A HOUTAKKER · (Male)

Reviews for JEREMY A HOUTAKKER

JEREMY A HOUTAKKER, PA – NPI #1902092109
Surgical