Search › Illinois › 363LN0000X
Jesse Henneberg, APN
NPI 1316299456 · on the registry since 2012 · sole proprietor
Practice
- Address
- 530 Ne Glen Oak Ave
Peoria, IL 61637 - Phone
- (309) 624-0629
- Organisation at this address
- University Of Illinois
University Of Illinois
St. Francis Medical Center
Saint Francis Medical Center
Saint Francis Medical CenterInferred from a shared address, not stated in the registry. - Clinicians at this address
- 1,001
Additional practice sites
- 415 N 9th St Ste 4w16, Springfield, IL
Registry record
- Primary taxonomy
- 363LN0000X
363LN0000X
- Also registered as
- 363LN0005X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-07-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois