Search › Illinois › 363LF0000X
Ebony Penn
NPI 1477137693 · on the registry since 2021
Practice
- Address
- 1720 Shadow Ridge Ct Apt H
Belleville, IL 62221 - Phone
- (618) 409-3082
Registry record
- Primary taxonomy
- 363LF0000X
363LF0000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-05-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois