Individual
REBECCA PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4192
(217) 876-8121
Mailing address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-8121
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209031723
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041453722
RN LICENSE
IL
Enumeration date
12/30/2024
Last updated
02/28/2025
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