Individual
NISA MALEKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.027076
IL
Other
Enumeration date
06/15/2023
Last updated
07/05/2023
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