Individual
DANIELLE N RENNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1188 SOUTH STATE ROUTE 157, SUITE 100, EDWARDSVILLE, IL 62025
(618) 692-5900
(618) 692-5901
Mailing address
1188 SOUTH STATE ROUTE 157, SUITE 100, EDWARDSVILLE, IL 62025
(618) 692-5900
(618) 692-5901
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2090165856
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2090165856
ILLINOIS LICENSE
IL
Enumeration date
01/09/2018
Last updated
05/07/2024
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