Individual
JENNIFER JO SIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 PAULS DR, MATTOON, IL 61938-6773
(217) 235-1689
Mailing address
3418 LAKE RD, MATTOON, IL 61938-6708
(217) 246-6807
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
IL
376K00000X
Nurse's Aide
Primary
—
IL
Other
Enumeration date
04/20/2016
Last updated
04/20/2016
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