Individual
MR. DAVID J FLETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MPH FACOEM
Contact information
Practice address
1806 N MARKET ST, CHAMPAIGN, IL 61822
(217) 356-6150
(217) 356-7167
Mailing address
1806 N MARKET ST, CHAMPAIGN, IL 61822
(217) 356-6150
(217) 356-7167
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036071408
IL
2083X0100X
Occupational Medicine Physician
Primary
036071408
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213008
—
IL
05
—
K25107
—
IL
Enumeration date
11/20/2006
Last updated
10/18/2012
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