Individual
JESSIE G HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
602 W UNIVERSITY AVE, URBANA, IL 61801-2530
(217) 383-3311
Mailing address
PO BOX 6002, URBANA, IL 61803-6002
(217) 326-8300
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036046935
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533210001
DMERC
IL
Enumeration date
02/22/2007
Last updated
05/20/2011
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