Individual
JESSICA FORD-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2274
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(248) 736-6300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125070529
IL
Other
Enumeration date
06/06/2017
Last updated
02/25/2022
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