Individual
JEREMY MEDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1701 W. CURTIS ROAD, DERMATOLOGY, CHAMPAIGN, IL 61822
(217) 365-6204
(217) 326-1234
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801-2529
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
85002513
IL
Other
Enumeration date
01/15/2007
Last updated
05/07/2014
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