Individual
MALLORIE ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
516 W MADISON ST, DANVILLE, IL 61832-5657
(217) 431-7850
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.028003
IL
Other
Enumeration date
08/08/2023
Last updated
05/13/2025
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