Individual
DERRIK ABELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
513 N MAIN ST, ANNA, IL 62906-1697
(618) 833-4471
Mailing address
513 N MAIN ST, ANNA, IL 62906-1697
(618) 833-4471
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.007900
IL
363A00000X
Physician Assistant
PA2020-0089
NM
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/23/2020
Last updated
06/21/2023
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