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Individual

JAMIE L MCGINNESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
900 N 1ST ST, SPRINGFIELD, IL 62702-3749
(217) 528-7541
Mailing address
1191 FORTUNE BLVD, STE 2, SHILOH, IL 62269-7377
(618) 622-7546

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036124865
IL
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
036124865
IL

Other

Enumeration date
06/10/2006
Last updated
08/03/2017
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