Individual
JEANNE MARIE DALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1485
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1485
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209011749
IL
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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