Individual
KENNA COURTNEY STEPHANIE ALTOBELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-2670
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-2670
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041323580
IL
364SA2200X
Adult Health Clinical Nurse Specialist
18805
SC
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
209011315
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP4873
—
SC
Enumeration date
03/03/2014
Last updated
04/08/2026
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