Individual
AUSTIN J SPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1051 W US ROUTE 6 STE 100, MORRIS, IL 60450-3370
(815) 942-4875
(815) 942-5046
Mailing address
725 SCHOOL ST STE A, MORRIS, IL 60450-1207
(815) 941-9124
(815) 941-4363
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.023541
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.023541
IL LICENSE
IL
Enumeration date
07/13/2021
Last updated
07/13/2021
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