Individual
ALISA DANIELLE PATTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3710 W VERNER DR, PEORIA, IL 61615-2990
(773) 916-1292
Mailing address
3710 W VERNER DR, PEORIA, IL 61615-2990
(773) 916-1292
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02252019
—
IL
Enumeration date
04/01/2021
Last updated
10/03/2023
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