person
Jennifer R Sunderland, PA-C
Medical Physician Assistant in Decatur, Illinois
NPI 1659475655

Jennifer R Sunderland is a Medical Physician Assistant based in Springfield, IL and is specialized in Medical. Jennifer R Sunderland practices in Decatur, IL and has the professional credentials of PA-C. The NPI Number for Jennifer R Sunderland is 1659475655 and holds a License No. 085003210 (Illinois).

The current practice location address for Jennifer R Sunderland is 1750 E Lake Shore Dr, Decatur, IL and can be reached out via phone at 217-464-1200 and via fax at 217-464-1210. You can also correspond with Jennifer R Sunderland through the mailing address at PO BOX 19248, SPRINGFIELD, IL - 62794-9248 (mailing address contact number: 217-528-7541).

Location: 1750 E Lake Shore Dr, Decatur, IL, 62794-9248
person
Provider Profile Details
NPI Number
1659475655
Provider Name
Jennifer R Sunderland
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
1750 E Lake Shore Dr, Decatur, IL, 62794-9248
Phone Number
217-464-1200
Fax Number
217-464-1210
Provider Enumeration Date
09/11/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
202735 01 IL MEDICARE PTAN LOCALITY 15
215827 01 IL MEDICARE PTAN LOCALITY 99
604530 01 IL MEDICARE PTAN LOCALITY 16
institution
Provider Business Practice Location Address Details
Address
1750 E Lake Shore Dr
City
State
Zip
62521-3803
Phone Number
217-464-1200
Fax Number
217-464-1210
person
Provider Business Mailing Address Details
Address
Po Box 19248
City
State
Zip
62794-9248
Phone Number
217-528-7541
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
085003210 (Illinois)
Definition
Definition to come...
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