Search › Illinois › 343900000X
Jacob Ediba
NPI 1871950782 · on the registry since 2016 · sole proprietor
Practice
- Address
- 273 Keystone Dr Apt 5
Rantoul, IL 61866 - Phone
- (217) 418-7384
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-11-30
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