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Individual

MRS. ALISA LYNN MAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.P.N.

Contact information

Practice address
2323 WINDISH DR, GALESBURG, IL 61401-9780
(309) 344-4200
(309) 344-4281
Mailing address
PO BOX 111, ONEIDA, IL 61467-0111
(309) 483-6266

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043-102526
IL
171M00000X
Case Manager/Care Coordinator
043-102526
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
043-102526
DPR
IL
01
370984175
FEIN BWAY ORG
IL
Enumeration date
03/27/2007
Last updated
04/14/2009
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