Individual
TARA MALINOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
207 LANDMARK DR STE A, NORMAL, IL 61761-3195
(309) 268-3200
Mailing address
611 W. PARK ST, FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
209020267
IL
Other
Enumeration date
10/24/2019
Last updated
06/09/2021
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