Individual
CICILY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 FOX DR, CHAMPAIGN, IL 61820-7236
(217) 398-7785
Mailing address
70 E WASHINGTON ST, CHAMPAIGN, IL 61820-3652
(217) 398-7785
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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