Individual
MARY L BRENNAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5401 N KNOXVILLE AVE, SUITE 119, PEORIA, IL 61614-5098
(309) 692-1700
(309) 692-1771
Mailing address
PO BOX 9726, PEORIA, IL 61612-9726
(309) 671-8749
(309) 671-8740
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
IL
Other
Enumeration date
06/16/2006
Last updated
07/09/2007
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