Individual
AMANDA S SAILLIEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
19 E SHAWNEE DR STE 2, MURPHYSBORO, IL 62966-7072
(618) 684-2172
(618) 687-4480
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002568
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085002568
—
IL
Enumeration date
02/17/2006
Last updated
05/15/2023
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