Individual
JULIA A BANCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
6294 STATE HWY 154, SESSER, IL 62884
(618) 625-6979
(618) 625-5362
Mailing address
PO BOX 155, CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORP, CHRISTOPHER, IL 62822
(618) 724-2401
(618) 724-2571
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036098406
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098406
—
IL
01
—
049587
HEALTH ALLIANCE
—
01
—
413721
HEALTHLINK
—
Enumeration date
12/27/2005
Last updated
10/25/2011
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