Individual
JAN N UPALAKALIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-9011
Mailing address
10335 N PORT WASHINGTON RD, MEQUON, WI 53092-5763
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
IL
Other
Enumeration date
07/08/2006
Last updated
10/30/2007
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