Individual
MR. RAFAEL SUELLO PLENOS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CNP
Contact information
Practice address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 766-7334
(815) 766-9768
Mailing address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 766-7334
(815) 766-9768
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209021145
IL
363LF0000X
Family Nurse Practitioner
209021145
IL
Other
Enumeration date
11/30/2020
Last updated
08/25/2022
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