Individual
RONALD AURTHUR DEGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RSA, SA-C, CSA
Contact information
Practice address
1804 GLENBRIDGE RD, BLOOMINGTON, IL 61704-8769
(309) 831-8326
Mailing address
1804 GLENBRIDGE RD, BLOOMINGTON, IL 61704-8769
(309) 831-8326
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238.000139
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238.000139
STATE OF ILLINOIS REGISTRATION NUMBER
IL
Enumeration date
02/12/2007
Last updated
06/06/2013
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