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Individual

JO BATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1096 1350TH ST, LINCOLN, IL 62526
(217) 735-5581
Mailing address
1641 N WOLFE ST, SPRINGFIELD, IL 62702
(217) 622-6877

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043073299
IL

Other

Enumeration date
01/13/2014
Last updated
01/13/2014
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