Individual
DR. JAMIE BEVERSDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5401 N KNOXVILLE AVE, PEORIA, IL 61614-5098
(309) 689-6093
Mailing address
5401 N KNOXVILLE AVE, PEORIA, IL 61614-5098
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125-049768
IL
208000000X
Pediatrics Physician
125-049768
IL
Other
Enumeration date
07/05/2007
Last updated
01/28/2019
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