Individual
TONYA K MCDOUGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3168
(309) 676-8123
(309) 676-8455
Mailing address
420 NE GLEN OAK AVE STE 401, PEORIA, IL 61603-3112
(309) 676-8123
(309) 676-8455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209001236
IL
363LF0000X
Family Nurse Practitioner
209001236
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00092881
RAILROAD MEDICARE
IL
Enumeration date
03/08/2007
Last updated
01/16/2025
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