Organization
LIFELONG ACCESS
Active
Other names
Marcfirst
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK DYCE BAILEY (PROGRAM SUPPORTS SPECIALIST)
(309) 451-8888
Entity
Organization
Contact information
Practice address
1302 FRANKLIN AVE STE L500, NORMAL, IL 61761-3551
(309) 452-0069
Mailing address
2000 JACOBSSEN DR, NORMAL, IL 61761-6277
(309) 451-8888
(309) 451-8989
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
Other
Enumeration date
01/03/2023
Last updated
08/27/2024
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