Individual
MS. GINA C. BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-1248
(217) 366-6100
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1248
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085002358
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
434110
MEDICARE GROUP
IL
01
—
P00168412
RAILROAD MEDICARE
IL
Enumeration date
08/01/2006
Last updated
01/05/2022
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