Individual
MARY JAYNE ZONFRILLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2500
(217) 383-3326
Mailing address
PO BOX 6004, URBANA, IL 61803-6004
(217) 383-6792
(217) 326-2856
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209002856
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036080035
—
IL
Enumeration date
01/04/2012
Last updated
08/01/2012
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