Individual
ANDRILYN NEDEDOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
308 APPLETON LN, LAKE VILLA, IL 60046-6405
(224) 330-7751
Mailing address
308 APPLETON LN, LAKE VILLA, IL 60046-6405
(224) 330-7751
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
209.016674
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209.016674
IL
Other
Enumeration date
10/11/2017
Last updated
10/17/2017
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