Individual
HOLLY ERIN DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 W. CURTIS RD, CHAMPAIGN, IL 61822-9678
(217) 365-6207
(217) 365-6380
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036136967
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/03/2011
Last updated
03/19/2015
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