Jerry Antonini

NPI #1386736023 in Bloomington, Illinois

Provider Information

NPI Number: 1386736023
Entity Type: Individual
Name: Jerry Antonini
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Enumeration Date: Sep 29, 2006
Last Updated: Apr 9, 2008

Practice Location

Address: 1505 EASTLAND DRIVE
Address 2: SUITE 320
City: Bloomington
State: Illinois
ZIP Code: 61701-3534
Phone: (309) 661-2368

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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