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Individual

AMANDA DOYLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
304 RANDALL RD, GENEVA, IL 60134-4200
(630) 232-0610
(630) 352-5499
Mailing address
304 RANDALL RD, GENEVA, IL 60134-4200
(630) 232-0610

Taxonomy

Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
041430219
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206147
MEDICARE PTAN GROUP
IL
01
F400235480
MEDICARE PTAN INDIVIDUAL
IL
Enumeration date
07/28/2015
Last updated
12/06/2016
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