Individual
JENNIFER SUE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
2414 W SHERMAN AVE, WEST PEORIA, IL 61604-5460
(309) 453-7887
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
125.053318
IL
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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