Individual
MARISSA EDELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5114 N GLEN PARK PLACE RD, PEORIA, IL 61614-4686
(309) 655-2431
Mailing address
217 REABA AVE, CONGERVILLE, IL 61729-9577
(309) 448-2433
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209.022682
IL
Other
Enumeration date
11/08/2021
Last updated
11/08/2021
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