Individual
MR. LISA M BUSENITZ JABLONSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8600 N STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9506
(309) 692-5393
(309) 692-2538
Mailing address
8600 N STATE ROUTE 91, SUITE 250, PEORIA, IL 61615-9506
(309) 692-5393
(309) 692-2538
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
041249104
IL
Other
Enumeration date
06/27/2006
Last updated
10/30/2013
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