Individual
LUCILLE ELIZABETH SMALLHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
516 W MADISON ST, DANVILLE, IL 61832-5657
(217) 962-1892
Mailing address
904 BELLEPARK DR, CHAMPAIGN, IL 61821-4172
(217) 962-1892
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
209.028680
IL
363LF0000X
Family Nurse Practitioner
Primary
209028680
IL
Other
Enumeration date
12/06/2023
Last updated
03/05/2024
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