Individual
JASON RICHARD HUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2022 E TAYLOR ST, BLOOMINGTON, IL 61701-5716
(309) 264-4571
Mailing address
2022 E TAYLOR ST, BLOOMINGTON, IL 61701-5716
(309) 264-4571
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090388
HEALTH ALLIANCE
IL
01
—
617982
HEALTHLINK
IL
01
—
7232002
BCBS
IL
01
—
7311298
AETNA
IL
01
—
P00229821
RR#
IL
Enumeration date
02/25/2006
Last updated
07/08/2007
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