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General NPI Number Information
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NPI Number | 1871725515
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Entity Type | Individual
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Provider Name | VALERIE A. CORWIN PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/13/2009
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 1505 EASTLAND DR STE 1100
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City | BLOOMINGTON
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State | IL
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Zip | 61701-7905
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Country | US
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Telephone | 309-663-2100
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Fax | 309-663-8322
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Provider Business Mailing Address
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Address Line | 1505 EASTLAND DR STE 1100
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City | BLOOMINGTON
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State | IL
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Zip | 61701-7905
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Country | US
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Telephone | 309-663-2100
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Fax | 309-663-8322
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085003526
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License Number State | IL
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