Individual
ISTA ARIANE EGBETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 MEMORIAL DR FL 1, DECATUR, IL 62526-3950
(217) 872-2930
(217) 872-2979
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-8000
(844) 470-2486
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036174078
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2021
Last updated
11/24/2025
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