Individual
MRS. SANDRA A FADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1111 TRINITY LN STE 111, BLOOMINGTON, IL 61704-8112
(309) 663-6461
(309) 663-5711
Mailing address
611 W. PARK ST, FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209016547
IL
363LF0000X
Family Nurse Practitioner
209016547
IL
Other
Enumeration date
09/28/2017
Last updated
01/29/2025
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