Individual
BRIAN J CUMMINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1802 S. MATTIS AVENUE, ORTHOPEDICS, CHAMPAIGN, IL 61821
(217) 383-7676
(217) 383-4910
Mailing address
PO BOX 6002, URBANA, IL 61803-6002
(217) 326-8300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-002639
IL
363A00000X
Physician Assistant
85002639
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533210001
DMERC #
IL
Enumeration date
08/20/2006
Last updated
11/21/2013
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