Individual
MARY COVENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2981 N MAIN ST, DECATUR, IL 62526-3259
(217) 877-9775
Mailing address
2981 N MAIN ST, DECATUR, IL 62526-3259
(217) 877-9775
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
041-213160
IL
Other
Enumeration date
12/13/2006
Last updated
10/16/2012
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