Search › Illinois › 363L00000X
Dietra Angelly, FNP-C
NPI 1902371313 · on the registry since 2018 · sole proprietor
Practice
- Address
- 3411 Professional Park Dr
Marion, IL 62959 - Phone
- (618) 969-8630
- Fax
- (618) 993-1421
- Organisation at this address
- Deaconess Illinois Clinic, Inc
Southern Illinois Medical Care Associates LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 8
Registry record
- Primary taxonomy
- 363L00000X
363L00000X
- Also registered as
- 363LF0000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-04-08
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