Individual
JENNIFER UPHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1505 EASTLAND DR, BLOOMINGTON, IL 61701-3534
(309) 663-2100
(309) 663-8322
Mailing address
1505 EASTLAND DR, BLOOMINGTON, IL 61701-3534
(309) 663-2100
(309) 663-8322
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-004447
IL
Other
Enumeration date
02/13/2013
Last updated
11/11/2014
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