Individual
ALGER PENAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2300 S 1ST ST, CHAMPAIGN, IL 61820-7661
(217) 383-9400
(217) 383-9691
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801-2529
(217) 383-6941
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209015192
IL
Other
Enumeration date
02/16/2017
Last updated
03/05/2024
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