Individual
TINA WHITE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1419 S FOLKERS AVE, PEORIA, IL 61605-1356
(309) 676-7803
Mailing address
5100 RELIABLE PARKWAY, CHICAGO, IL 60686-0001
(309) 676-7803
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
IL
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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