person
Julie A Desutter, PA
Medical Physician Assistant in Peoria, Illinois
NPI 1093847600

Julie A Desutter is a Medical Physician Assistant based in Peoria, IL and is specialized in Medical. Julie A Desutter practices in Peoria, IL and has the professional credentials of PA. The NPI Number for Julie A Desutter is 1093847600 and holds a License No. 085001405 (Illinois).

The current practice location address for Julie A Desutter is 200 E Pennsylvania Ave, Peoria, IL and can be reached out via phone at 309-676-8123 and via fax at 309-676-8455.

Location: 200 E Pennsylvania Ave, Peoria, IL, 61603-3089
person
Provider Profile Details
NPI Number
1093847600
Provider Name
Julie A Desutter
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
200 E Pennsylvania Ave, Peoria, IL, 61603-3089
Phone Number
309-676-8123
Fax Number
309-676-8455
Provider Enumeration Date
03/09/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P00016083 01 IL RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
200 E Pennsylvania Ave
City
State
Zip
61603-3089
Phone Number
309-676-8123
Fax Number
309-676-8455
person
Provider Business Mailing Address Details
Address
200 E Pennsylvania Ave
City
State
Zip
61603-3089
Phone Number
309-676-8123
Fax Number
309-676-8455
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
085001405 (Illinois)
Definition
Definition to come...
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