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Individual

DR. JO ANN ARCHEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
209 W BORMAN DR, RANTOUL, IL 61866-3632
(217) 892-9671
(217) 892-2530
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-8107
(217) 366-6106

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-110125
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036110125 1
IL
01
279500
MEDICARE GROUP
IL
01
P00129449
RAILROAD MEDICARE
IL
Enumeration date
07/31/2006
Last updated
01/05/2022
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