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Individual

JEFFREY B ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
6000 N ALLEN ROAD, PEORIA, IL 61614-3294
(309) 691-1400
Mailing address
6000 N ALLEN ROAD, PEORIA, IL 61614-3294
(309) 691-1400

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363AS0400X
Surgical Physician Assistant
085001791
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
085001791
IL
Enumeration date
05/16/2006
Last updated
10/26/2020
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