Individual
REBECCA ULTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
7309 N KNOXVILLE AVE, PEORIA, IL 61614-2085
(309) 692-9898
(309) 692-9055
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085002060
IL
Other
Enumeration date
04/25/2006
Last updated
02/24/2025
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