Provider Demographics
NPI:1508853151
Name:HONCHARUK, JOHN LANDERS (ATC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:LANDERS
Last Name:HONCHARUK
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2671 ASBURY DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-3213
Mailing Address - Country:US
Mailing Address - Phone:847-343-2579
Mailing Address - Fax:
Practice Address - Street 1:1820 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1634
Practice Address - Country:US
Practice Address - Phone:630-928-3400
Practice Address - Fax:630-762-1230
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096-0009212255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer