Individual
ABBY A PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-6880
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-5302
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
041315919
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062839
UMWA
IL
01
—
02922981
BCBS
IL
05
—
041315919
—
IL
01
—
107762
HEALTH ALLIANCE
IL
01
—
1942315197
NPI CLINIC NUMBER
IL
Enumeration date
08/29/2006
Last updated
05/05/2021
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