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NPI 1427709112 · on the registry since 2022 · sole proprietor
Practice
- Address
- 15 E Hazel Dell Ln
Springfield, IL 62712 - Phone
- (217) 585-5437
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 171M00000X
171M00000X
- Also registered as
- 103K00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-03-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois