Individual
SANDRA D CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
535 ERMA DR, SOMONAUK, IL 60552-9501
(815) 826-0490
Mailing address
535 ERMA DR, SOMONAUK, IL 60552-9501
(815) 826-0490
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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