Individual
DR. JODIE DEWEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
302 SAINT JOSEPH DR, BLOOMINGTON, IL 61701-3506
(309) 664-3100
(309) 664-3027
Mailing address
302 SAINT JOSEPH DR, BLOOMINGTON, IL 61701-3506
(309) 664-3100
(309) 664-3027
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036088592
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL2613
MEDICARE GROUP #
—
Enumeration date
07/14/2006
Last updated
04/22/2014
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