Individual
ANGELA MARIE DILLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
294 KINGS RIDGE BLVD, O FALLON, IL 62269-6330
(618) 975-3781
Mailing address
900 MULLANPHY RD, FLORISSANT, MO 63031-3231
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
28361A
MO
Other
Enumeration date
11/09/2018
Last updated
11/09/2018
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