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Individual

SYDNEY DESOLLAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3000
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.454524
IL
363L00000X
Nurse Practitioner
Primary
209025758
IL
363LF0000X
Family Nurse Practitioner
209.025758
IL

Other

Enumeration date
01/19/2021
Last updated
02/19/2025
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