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Malorie Defore
NPI 1992390843 · on the registry since 2021 · sole proprietor
Practice
- Address
- 1205 Indiana Ave
Mendota, IL 61342 - Phone
- (815) 414-1136
Registry record
- Primary taxonomy
- 225X00000X
225X00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-03-03
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