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Individual

ALISON M PEDDYCOART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1836 S MACARTHUR BLVD, SPRINGFIELD, IL 62704-4000
(217) 789-1403
(217) 525-1624
Mailing address
1836 S MACARTHUR BLVD, SPRINGFIELD, IL 62704-4000
(217) 789-1403
(217) 525-1624

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209018326
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041399583
RN LICENSE
IL
Enumeration date
07/23/2018
Last updated
10/08/2024
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