Individual
JASMINE PRAMOJ ACFALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
815 MAIN ST STE C, PEORIA, IL 61602-1080
(309) 672-4986
Mailing address
815 MAIN ST STE C, PEORIA, IL 61602-1080
(309) 672-4986
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.084698
IL
390200000X
Student in an Organized Health Care Education/Training Program
0000000000000
—
Other
Enumeration date
04/08/2024
Last updated
07/16/2024
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