Individual
MARY ELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
300 SATTLEY ST, ROCHESTER, IL 62563-9241
(217) 789-3630
Mailing address
300 SATTLEY ST, ROCHESTER, IL 62563-9241
(217) 789-3630
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277000332
IL
Other
Enumeration date
06/22/2006
Last updated
12/29/2021
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