Foss, Jonathan M

Foss, Jonathan M is an individual health care provider with primary practice located at 2200 Fort Jesse Rd , Normal IL 61761-6286. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Foss, Jonathan M can be contacted via phone (309) 452-1788.

Contact Information

Primary practice address
2200 Fort Jesse Rd Normal IL 61761-6286
Phone: (309) 452-1788
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME161552 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 36085058 Illinois

Profile Details

NPI number 1265471486
LBN Legal business name Foss, Jonathan M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Oct 16th, 2023 - about last year

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 1265471486 NPPES
Illinois MEDICAID 036085058*2

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