Individual
SUSAN WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
928 W MOUNT VERNON ST, METAMORA, IL 61548-6004
(309) 367-2229
Mailing address
928 W MOUNT VERNON ST, METAMORA, IL 61548-6004
(309) 367-2229
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-011733
IL
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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