Individual
JACOB DAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
Mailing address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085011901
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/11/2024
Last updated
02/02/2026
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