De Venecia, Michael

De Venecia, Michael is an individual health care provider with primary practice located at 841 Broadmeadow Rd , Rantoul IL 61866-2166. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. De Venecia, Michael can be contacted via phone (217) 282-3010.

Contact Information

Primary practice address
841 Broadmeadow Rd Rantoul IL 61866-2166
Phone: (217) 282-3010
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085009622 Illinois

Profile Details

NPI number 1457046351
LBN Legal business name De Venecia, Michael
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2023
Last updated Apr 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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