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Individual

MR. JIA DONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA, APNP

Contact information

Practice address
1000 HEALTH CENTER DR, MATTOON, IL 61938-4644
(217) 258-2440
(217) 258-2186
Mailing address
1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938-4653

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
17827-033
WI
367500000X
Certified Registered Nurse Anesthetist
209.020980
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1801420559
WI
Enumeration date
03/02/2020
Last updated
02/23/2026
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