Individual
MR. JAMES B. CORNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1237
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1237
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001670
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
279500
MEDICARE GROUP
IL
01
—
P00237915
RAILROAD MEDICARE
IL
Enumeration date
08/01/2006
Last updated
06/17/2008
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