Individual
DR. PARKER JAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1505 EASTLAND DR, LL 1400, BLOOMINGTON, IL 61701-3534
(309) 663-4700
(309) 665-0575
Mailing address
1505 EASTLAND DR, LL 1400, BLOOMINGTON, IL 61701-3534
(309) 663-4700
(309) 665-0575
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036098712
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
036098712
IL
Other
Enumeration date
12/22/2005
Last updated
10/08/2020
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