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Individual

DORTHIA D CAMERON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-8820
(309) 624-8820
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-8820
(309) 624-8820

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
6647
WI
363LP2300X
Primary Care Nurse Practitioner
Primary
209030955
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100054093
WI
Enumeration date
01/09/2016
Last updated
07/28/2025
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