Individual
KEVIN SPANGLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1120 E WAR MEMORIAL DR, PEORIA HEIGHTS, IL 61616
(309) 685-4411
Mailing address
1120 E WAR MEMORIAL DR, PEORIA HEIGHTS, IL 61616-7757
(309) 685-4411
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209017904
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209017904
LICENSE
IL
Enumeration date
04/09/2014
Last updated
08/15/2018
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