Individual
HOLLI A SPATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADP
Contact information
Practice address
2130 POINT BLVD STE 900, ELGIN, IL 60123-9214
(888) 220-6432
Mailing address
3002 KING JAMES AVE, ST CHARLES, IL 60174-7832
(847) 477-6965
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209019304
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209019304
IL STATE LIC BOARD
IL
Enumeration date
12/02/2019
Last updated
12/02/2019
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