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Individual

THOMAS CORNELIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 373-2430
Mailing address
202 W. PARK ST., CHAMPAIGN, IL 61820
(217) 373-2430

Taxonomy

Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary

Other

Enumeration date
11/01/2006
Last updated
07/08/2007
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