Individual
ADEBIMPE FAVOUR EREBHOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3300 N MAIN ST, EAST PEORIA, IL 61611-1562
(309) 698-8300
(309) 698-8303
Mailing address
3300 N MAIN ST, EAST PEORIA, IL 61611-1562
(309) 698-8300
(309) 698-8303
Taxonomy
Speciality
Code
Description
License number
State
163WN0300X
Nephrology Registered Nurse
041434445
IL
363L00000X
Nurse Practitioner
Primary
209022026
IL
Other
Enumeration date
08/03/2020
Last updated
09/17/2020
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