Individual
ANN LAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2500
(217) 383-3507
(217) 383-6006
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
(217) 383-4752
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
209.011650
IL
Other
Enumeration date
09/01/2014
Last updated
09/16/2014
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