Individual
ARI ALEXANDRA PENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 W WINDSOR RD, CHAMPAIGN, IL 61822-6217
(217) 366-6104
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-6104
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036160991
IL
207Q00000X
Family Medicine Physician
1174028971
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/26/2018
Last updated
08/23/2022
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