Individual
MRS. MARY ANN GOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2300 N EDWARD ST, SUITE 3200, DECATUR, IL 62526-4163
(217) 876-3660
(217) 876-3665
Mailing address
2300 N EDWARD ST, GSBLL, DECATUR, IL 62526-4163
(217) 876-2857
(217) 876-2874
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004263
IL
Other
Enumeration date
01/05/2012
Last updated
09/04/2014
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