Individual
MRS. DELLENIA DALE HAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1306 MAPLE ST, DOCTORS CLINIC, ELDORADO, IL 62930
(618) 273-2360
(618) 273-4418
Mailing address
PO BOX 155, REA CLINIC, CHRISTOPHER, IL 62822
(618) 724-2401
(618) 724-2571
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
IL
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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