Individual
MONICA PLYMALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 N MAIN ST, ROCKFORD, IL 61103-1277
(815) 921-9200
(815) 877-8304
Mailing address
4401 N MAIN ST, ROCKFORD, IL 61103-1277
(815) 921-9200
(815) 877-8304
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
044010510
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
366006681
—
IL
Enumeration date
06/01/2016
Last updated
06/01/2016
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