Individual
LISA ANN PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
4412 W JEWELWOOD CT, PEORIA, IL 61615-8932
(309) 657-4601
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.021062
IL
Other
Enumeration date
12/29/2020
Last updated
12/29/2020
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