Individual
JACK CHARLES MORKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
119 N WILLIAMSBURG DR, BLOOMINGTON, IL 61704-3528
(309) 663-1326
Mailing address
2706 SHEPARD RD, NORMAL, IL 61761-6434
(309) 824-6952
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.034446
IL
Other
Enumeration date
07/05/2023
Last updated
03/03/2025
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