Individual
MARIANA RICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
309 W CLARK ST, CHAMPAIGN, IL 61820-4637
(217) 398-9066
(217) 398-9077
Mailing address
309 W CLARK ST, CHAMPAIGN, IL 61820-4637
(217) 398-9066
(217) 398-9077
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209021890
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209021890
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
11/17/2021
Last updated
03/07/2023
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