Individual provider · Type 1 NPI

Julie A. Desutter, PA

Medical Physician Assistant · Peoria, IL

NPI number 1093847600 Active

Practice location

200 E Pennsylvania Ave, Suite 212
Peoria, IL 61603-3089

Fax (309) 676-8455

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X085001405 (IL)

Medical Physician Assistant: Definition to come...

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About NPI 1093847600

Julie A. Desutter, PA's National Provider Identifier is 1093847600, issued on Mar 9, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Peoria, IL. The record was last updated on Dec 11, 2008.