Individual
ELLYN DIANE DEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 373-2430
Mailing address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 373-2430
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
41217802
IL
Other
Enumeration date
07/23/2007
Last updated
07/23/2007
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