Individual
DR. JESSICA JEAN PRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
503 N MAPLE ST, EFFINGHAM, IL 62401-2006
(217) 342-2121
(217) 347-1563
Mailing address
503 N MAPLE ST, EFFINGHAM, IL 62401-2006
(217) 342-2121
(217) 347-1563
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0036.137347
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036137347
—
IL
01
—
P01514409
RAILROAD
IL
Enumeration date
04/10/2009
Last updated
12/21/2021
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