Individual
JENNIFER MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3333 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 344-3161
(309) 344-9448
Mailing address
3333 N SEMINARY ST, GALESBURG, IL 61401-1251
(309) 344-3161
(309) 344-9448
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036169202
IL
390200000X
Student in an Organized Health Care Education/Training Program
390200000X
IL
Other
Enumeration date
05/17/2021
Last updated
06/03/2024
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