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Individual

GABRIELLE R DIMARZIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2950 S 6TH ST, SPRINGFIELD, IL 62703-5904
(217) 588-2600
Mailing address
2950 S 6TH ST, SPRINGFIELD, IL 62703-5904
(217) 588-2600

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.028273
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041474495
RN LICENSE
IL
Enumeration date
11/07/2023
Last updated
12/13/2023
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