Individual
CARLEY ELIZABETH PROMISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
126 N 5TH AVE, CANTON, IL 61520-2800
(309) 647-0201
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209028861
IL
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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