Individual
DANIELLE MARIE EVERETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16519 S ROUTE 59, PLAINFIELD, IL 60586-2607
(630) 870-7310
Mailing address
609 REBECCA LN, BOLINGBROOK, IL 60440-4859
(630) 392-5025
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004210
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831475466
NPI GROUP NUMBER
IL
Enumeration date
09/06/2012
Last updated
03/08/2023
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