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Individual

MARILEE KAE HARVEY CRAMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2901 OLD JACKSONVILLE RD, SPRINGFIELD, IL 62704-7437
(217) 698-9722
(217) 391-0392
Mailing address
PO BOX 500, CHATHAM, IL 62629-0500
(217) 670-2424
(217) 670-2809

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041206732
IL
164W00000X
Licensed Practical Nurse
209002225
IL
363L00000X
Nurse Practitioner
Primary
041206732
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020057300
BLACK LUNG
IL
01
041206732
IL STATE LICENSE
IL
01
064699
HEALTH ALLIANCE
IL
01
08421024
BC/BS
IL
01
133586700
ACS-OWCP
IL
01
14D0949277
CLIA
IL
01
209002225
IL ADVANCED PRAC NURS LIC
IL
01
323742
HEALTHLINK
IL
01
500012379
RR MEDICARE PIN
IL
01
6394P
CATERPILLAR
IL
01
CD7143
RR MEDICARE GROUP
IL
Enumeration date
08/05/2006
Last updated
09/30/2014
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