Individual
JEREMY GOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3101 FIELDS SOUTH DR, CHAMPAIGN, IL 61822-3743
(217) 366-1240
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-8107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004264
IL
Other
Enumeration date
01/05/2012
Last updated
01/15/2025
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