Individual
JESSICA PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N SYCAMORE ST, VILLA GROVE, IL 61956-9771
(217) 832-2261
Mailing address
1705 GENTRY SQUARE LN APT 106, CHAMPAIGN, IL 61821-5973
(319) 899-6686
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/07/2022
Last updated
10/07/2022
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