Individual
MISS AMANDA MARIE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8600 N STATE ROUTE 91, SUITE 300, PEORIA, IL 61615-9541
(309) 691-6616
(309) 691-2943
Mailing address
2401 W ALTA RD, APT. 1904, PEORIA, IL 61615-1279
(219) 508-5791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004220
IL
Other
Enumeration date
10/26/2011
Last updated
04/04/2023
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