Individual
ERIN P. O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
175 S MAIN ST, CANTON, IL 61520-2670
(309) 647-0201
(309) 649-5302
Mailing address
175 S MAIN ST, CANTON, IL 61520-2670
(309) 647-0201
(309) 649-5302
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062839
UMWA
IL
01
—
02922981
BCBS
IL
01
—
1942315197
NPI CLINIC NUMBER
IL
01
—
200397
BLACK LUNG
IL
01
—
CG5172
RR MEDICARE GROUP
IL
Enumeration date
01/30/2007
Last updated
12/27/2007
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