Michael De Venecia, PA-C

NPI #1457046351 in Rantoul, Illinois

Provider Information

NPI Number: 1457046351
Entity Type: Individual
Name: Michael De Venecia, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Apr 6, 2023
Last Updated: Apr 6, 2023

Practice Location

Address: 841 BROADMEADOW RD
City: Rantoul
State: Illinois
ZIP Code: 61866-2166
Phone: (217) 282-3010

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Medical — Medical	363AM0700X
Physician Assistant	363A00000X	Primary

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