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Individual

MICHELLE DIANNE NIEHAUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1025 MAINE ST, QUINCY, IL 62301-4096
(217) 222-6550
(217) 277-2253
Mailing address
1 UNIVERSITY CIR, MACOMB, IL 61455-1367

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
209.019108
IL
363L00000X
Nurse Practitioner
Primary
277004354
IL

Other

Enumeration date
04/02/2019
Last updated
07/23/2025
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