Individual
JACINDA ANNE CORNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6501 N SHERIDAN RD, PEORIA, IL 61614-2932
(309) 692-8110
(309) 692-8673
Mailing address
6501 N SHERIDAN RD, PEORIA, IL 61614-2932
(309) 692-8110
(309) 692-8673
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085-001587
IL
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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