Individual
JILL MARIE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-8464
(309) 655-6862
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-8464
(309) 655-6862
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209012545
IL
Other
Enumeration date
02/09/2015
Last updated
10/29/2019
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