Individual
JESSICA LYNN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
120 E 7TH ST, MINONK, IL 61760-1135
(309) 432-2515
(309) 432-2160
Mailing address
120 E 7TH ST, MINONK, IL 61760-1135
(309) 432-2515
(309) 432-2160
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-130541
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2009
Last updated
11/23/2012
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