Individual
JENNIFER LIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3105 FIELDS SOUTH DR, CHAMPAIGN, IL 61822-3743
(217) 902-7527
(217) 902-7755
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209013008
IL
Other
Enumeration date
08/11/2015
Last updated
04/23/2019
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