Individual
JUDITH A. MCCONVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN/CNP
Contact information
Practice address
1201 MERIDEN ST, MENDOTA, IL 61342-2501
(815) 539-3739
(815) 539-3753
Mailing address
1201 MERIDEN ST, MENDOTA, IL 61342-2501
(815) 539-3739
(815) 539-3753
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-006825
IL
Other
Enumeration date
11/05/2007
Last updated
12/14/2011
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