Individual
ELIZABETH PERNICONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-4998
(309) 655-7768
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
FL
Other
Enumeration date
03/25/2021
Last updated
03/19/2023
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