Individual
AMANDA GAWELEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-FNP-BC
Contact information
Practice address
5001 N UNIVERSITY ST, PEORIA, IL 61614-4799
(309) 693-2225
(309) 693-2228
Mailing address
5001 N UNIVERSITY ST, PEORIA, IL 61614-4799
(309) 693-2225
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209013391
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209013391
STATE LICENSE
IL
Enumeration date
10/20/2015
Last updated
01/26/2016
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