Individual
ANGELA J GILLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSFNP
Contact information
Practice address
411 MAXINE DR, MORTON, IL 61550-2495
(309) 263-2411
(309) 263-2208
Mailing address
411 MAXINE DR, MORTON, IL 61550-2495
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209005284
IL
Other
Enumeration date
05/25/2006
Last updated
08/20/2010
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