Individual
DR. JACQUELINE PENA VELASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-3088
(217) 383-4468
Mailing address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-3088
(217) 383-4468
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036166076
IL
Other
Enumeration date
09/14/2011
Last updated
03/05/2024
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