Individual
DR. JEAN CORRIVEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1209 N. MAIN ST., CHATHAM, IL 62629
(217) 483-5019
(217) 483-5019
Mailing address
PO BOX 303, CHATHAM, IL 62629
(217) 483-5019
(217) 483-5019
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19013801
IL
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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