Individual
MATTHEW J BEDNARCHIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
(217) 245-9541
Mailing address
1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
(217) 525-5643
(217) 544-3311
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209009383
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174580831
—
IL
Enumeration date
02/15/2012
Last updated
01/15/2021
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