Individual
JERMY ENRIQUE CRESPO GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 EAST WASHINGTON STREET, BLOOMINGTON, IL 61701
(309) 665-5996
Mailing address
2200 EAST WASHINGTON STREET, BLOOMINGTON, IL 61701
(309) 665-5996
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.085035
IL
Other
Enumeration date
01/29/2024
Last updated
07/14/2024
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