364SA2200X
Bloomington, IL
Specialty
364SA2200X
Credential
APN-CNS
NPI
1578964987
1505 Eastland Dr., Bloomington, IL 61701
(309) 661-5004Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 364sa2200x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 364SA2200X