Holley, Jean L.

Holley, Jean L. is an individual health care provider with primary practice located at 611 W. Park St. Nephrology, Urbana IL 61801-2500. She recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as her primary health care specialty. Holley, Jean L. can be contacted via phone (217) 383-3605.

Contact Information

Primary practice address
611 W. Park St. Nephrology Urbana IL 61801-2500
Phone: (217) 383-3605
Fax: (217) 383-2704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 0101231892 Virginia
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 03606251 Illinois

Profile Details

NPI number 1649349259
LBN Legal business name Holley, Jean L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2006
Last updated Oct 8th, 2015 - about 10 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 1649349259 NPPES
Virginia MEDICAID 005865051

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