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Jennifer Main
Student in an Organized Health Care Education/Training Program in Peoria, Illinois
NPI 1255905014

Jennifer Main is a Student in an Organized Health Care Education/Training Program based in Peoria, IL. Jennifer Main practices in Peoria, IL. The NPI Number for Jennifer Main is 1255905014 and holds a License No. 390200000X (Illinois).

The current practice location address for Jennifer Main is 530 Ne Glen Avenue, Peoria, IL and can be reached out via phone at 309-655-2109.

Location: 530 Ne Glen Avenue, Peoria, IL, 61637
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255905014
Provider Name
Jennifer Main
Credential
Provider Entity Type
Individual
Gender
Female
Address
530 Ne Glen Avenue, Peoria, IL, 61637
Phone Number
309-655-2109
Fax Number
Provider Enumeration Date
05/17/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
530 Ne Glen Avenue
City
Peoria
State
Illinois
Zip
61637
Phone Number
309-655-2109
Fax Number
person
Provider Business Mailing Address Details
Address
530 Ne Glen Avenue
City
Peoria
State
Illinois
Zip
61637
Phone Number
309-655-2109
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
390200000X (Illinois)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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