Individual
JAIME HUMBERTO CERCONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 W MILTON AVE, LEWISTOWN, IL 61542-1322
(309) 547-2135
(309) 547-1560
Mailing address
501 W MILTON AVE, LEWISTOWN, IL 61542-1322
(309) 547-2135
(309) 547-1560
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166124
—
IL
Enumeration date
11/07/2006
Last updated
05/10/2026
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