Individual
NICOLE DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
241 W WEAVER RD, SUITE 145B, FORSYTH, IL 62535-9762
(217) 794-5472
(217) 794-5458
Mailing address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-2868
(217) 876-2874
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-001647
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833120
MEDICARE GROUP #
—
01
—
CA2264
RR GROUP #
—
01
—
P00807365
RR INDIVIDUAL #
—
Enumeration date
12/13/2006
Last updated
04/28/2010
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us