Individual
AMANDA HUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4282 E ROCKTON RD, ROSCOE, IL 61073
(779) 696-9000
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-354723
IL
363LF0000X
Family Nurse Practitioner
209-011681
IL
363LF0000X
Family Nurse Practitioner
Primary
277-000572
IL
Other
Enumeration date
05/01/2014
Last updated
03/26/2021
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