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Individual

JASON R MICHAELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
701 N 1ST ST, SPRINGFIELD, IL 62702-3757
(217) 545-0182
(217) 545-4735
Mailing address
611 W. PARK ST, FAPC, URBANA, IL 61801

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036-145873
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036145873
IL

Other

Enumeration date
06/29/2014
Last updated
10/27/2021
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