Dameron, Jennifer S

Dameron, Jennifer S is an individual health care provider with primary practice located at 1302 Franklin Ave Suite 3400, Normal IL 61761-3551. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Dameron, Jennifer S can be contacted via phone (309) 451-9595.

Contact Information

Primary practice address
1302 Franklin Ave Suite 3400 Normal IL 61761-3551
Phone: (309) 451-9595
Fax: (309) 451-9583
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036112101 Illinois

Profile Details

NPI number 1679685879
LBN Legal business name Dameron, Jennifer S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679685879 NPPES
Illinois MEDICAID 036112101

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