Individual
JONATHAN AUBRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1111 TRINITY LN, BLOOMINGTON, IL 61704-8111
(309) 661-6414
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036157079
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2017
Last updated
08/17/2021
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