Individual
JERRY T METCALF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 756-1521
(815) 766-9647
Mailing address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 756-1521
(815) 766-9647
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
041-255087
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
209-002136
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209002136
IL
Other
Enumeration date
08/11/2005
Last updated
12/16/2025
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