Individual
JILL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1400 FINANCIAL PARK, CARBONDALE, IL 62902-7537
(618) 351-9140
(618) 351-9143
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020197
IL
Other
Enumeration date
10/10/2019
Last updated
12/05/2024
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