Individual
AMANDA J BORMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62702-5324
(217) 544-6464
Mailing address
1904 PERSIMMON AVE, CHATHAM, IL 62629-1598
(217) 741-6343
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
209030192
IL
363LF0000X
Family Nurse Practitioner
Primary
209030192
IL
Other
Enumeration date
08/02/2024
Last updated
02/19/2025
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