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Individual

JESSE TAO BUEDEFELDT-POLLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
421 N 9TH ST BLDG Q, SPRINGFIELD, IL 62702-5317
(217) 545-8000
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(844) 470-2486

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MD171594
OR
207VX0000X
Obstetrics Physician
Primary
036140756
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036140756
IL
Enumeration date
06/28/2011
Last updated
11/20/2025
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