Mr Justin Matthew Jefferson, | |
611 W Park St, Urbana, IL 61801-2529 | |
(217) 326-4325 | |
Not Available |
Full Name | Mr Justin Matthew Jefferson |
---|---|
Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 611 W Park St, Urbana, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073238440 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 209.025128 (Illinois) | Secondary |
363LF0000X | Nurse Practitioner - Family | 209025128 (Illinois) | Primary |
Entity Name | Carle Health Care Incorporated |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1154653947 PECOS PAC ID: 3577515774 Enrollment ID: O20100513000829 |
Mailing Address | Practice Location Address |
---|---|
Mr Justin Matthew Jefferson, 611 W. Park St., Fapc, Urbana, IL 61801 Ph: () - | Mr Justin Matthew Jefferson, 611 W Park St, Urbana, IL 61801-2529 Ph: (217) 326-4325 |
Lindy Drollinger, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 610 N. Lincoln Ave., Neurosurgery, Urbana, IL 61801 Phone: 217-383-3507 Fax: 217-383-3171 | |
Emily Remington, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 611 W Park St, Urbana, IL 61801 Phone: 217-383-3140 Fax: 217-383-4966 | |
Kendall E Wallace, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 611 W Park St, Urbana, IL 61801 Phone: 217-383-3311 | |
Jiaqiu Sinha, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 509 W University Ave, Urbana, IL 61801 Phone: 217-383-6645 | |
Mrs. Doris M Lawyer, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1109 S Lincoln Ave, Urbana, IL 61801 Phone: 217-333-2711 | |
Peter Kale, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1818 E. Windsor Road, Adult Medicine/geriatrics, Urbana, IL 61802 Phone: 217-255-9672 Fax: 217-383-4681 | |
Kelly Johnson, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1818 E. Windsor Road, Urbana, IL 61802 Phone: 217-255-9670 Fax: 217-255-9724 |