Individual
JENNIFER ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2127 SW JEFFERSON AVE, PEORIA, IL 61605-3645
(309) 674-4812
Mailing address
5100 RELIABLE PKWY, CHICAGO, IL 60686-0001
(309) 672-4809
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209007803
IL
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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