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Individual

MARY CATHERINE COURTNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 344-4255
Mailing address
2384 KNOX ROAD 165 E, RIO, IL 61472-9736
(309) 343-0733

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-282203
IL
163WC0400X
Case Management Registered Nurse
041-282203
IL
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
041-282203
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041-282203
STATE LICENSE
IL
01
370984175
FEIN BWAY INC
IL
Enumeration date
04/06/2007
Last updated
04/14/2009
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