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1376538124
JAYNE K FEDOR
SPRINGFIELD, IL
NPI
1376538124
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: IL 085001270)
Enumeration Date
2005-09-19
Last Update Date
2007-07-08
Business Address
-- JAYNE K FEDOR P.A.C.
751 N RUTLEDGE ST
SPRINGFIELD, IL 62702-4909
Phone number: 217-545-0173
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Mailing Address
-- JAYNE K FEDOR P.A.C.
PO BOX 19639
SPRINGFIELD, IL 62794-9639
Phone number: 217-545-7578
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