Individual
ANNA CICCIARELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0052
(309) 655-2000
Mailing address
111 OAKWOOD RD, EAST PEORIA, IL 61611-1853
(309) 740-4272
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
041366482
IL
363L00000X
Nurse Practitioner
Primary
209-009828
IL
Other
Enumeration date
08/06/2012
Last updated
03/07/2024
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