Individual
BROCK DANIEL THORNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2499
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209029931
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/31/2023
Last updated
05/01/2026
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