Individual
KAMI JO LARSON HARLESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
520 N 4TH ST, SPRINGFIELD, IL 62702-5238
(217) 545-8000
(217) 757-8161
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(844) 470-2488
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.142057
IL
207Q00000X
Family Medicine Physician
MD60587321
WA
207QA0401X
Addiction Medicine (Family Medicine) Physician
036.142057
IL
Other
Enumeration date
04/04/2013
Last updated
01/08/2024
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