Individual
DR. SANDRA LYNN ETTEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938-4653
(217) 258-2409
(217) 258-2323
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036.118460
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118460
—
IL
Enumeration date
10/04/2006
Last updated
11/08/2024
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