Individual
JAYME LEE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7303 N KNOXVILLE AVE, PEORIA, IL 61614-2017
(309) 691-4005
(309) 691-6144
Mailing address
7303 N KNOXVILLE AVE, PEORIA, IL 61614-2017
(309) 691-4005
(309) 691-6144
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006033
IL
363AS0400X
Surgical Physician Assistant
PA-616
AR
Other
Enumeration date
03/26/2015
Last updated
11/28/2016
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