Individual
JUDITH LIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
506 W LINCOLN AVE, SUITE 200 A, CHARLESTON, IL 61920-2453
(217) 348-8727
Mailing address
506 W LINCOLN AVE, SUITE 200 A, CHARLESTON, IL 61920-2453
(217) 348-8727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-000974
IL
Other
Enumeration date
08/22/2006
Last updated
02/06/2017
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