Individual
JONATHAN WILLIAM MOONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
228 NE JEFFERSON AVE, PEORIA, IL 61603-3802
(309) 671-8000
(309) 671-4695
Mailing address
600 FAYETTE ST, PEORIA, IL 61603-3610
(309) 671-8020
(309) 671-8007
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209
IL
Other
Enumeration date
08/02/2019
Last updated
08/21/2019
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