Individual
KRISTINA DAKIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
705 S DIXIE HWY, HOOPESTON, IL 60942-1904
(217) 283-5530
(217) 283-6437
Mailing address
1120 N MELVIN ST, GIBSON CITY, IL 60936-1477
(217) 283-5530
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.146067
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
370647938
MOLINA NUMBER
IL
Enumeration date
04/08/2015
Last updated
08/18/2020
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