Jessica L Secor
Vascular Surgeon
7725 N Knoxville Ave
Peoria
, Illinois 61614-2079
Jessica L Secor
Vascular Surgeon
7725 N Knoxville Ave
Peoria
, Illinois 61614-2079
(309) 689-9035
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Jessica L Secor
- 7725 N Knoxville Ave
- Peoria, IL
- Zip : 61614-2079
- Fax : (309) 689-9035
- Phone : (309) 495-0240
Second Address
- Jessica L Secor
- 7725 N Knoxville Ave
- Peoria, IL
- Zip : 61614-2079
- Fax : (309) 689-9035
- Phone : (309) 495-0250
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | 36140614 | IL |
National Provider Identifier
| NPI | 1164700183 |
|---|---|
| Provider Name | Jessica L Secor |
| First Address | Peoria, IL 61614-2079 |
| Second Address | Peoria, IL 61614-2079 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/07/2011 |
| Last Update Date | 02/06/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.