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1013504414
MARY T SAMULEVICH
SPRINGFIELD, IL
NPI
1013504414
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209020043)
Enumeration Date
2020-12-31
Last Update Date
2021-12-21
Business Address
MARY T SAMULEVICH APRN
2200 WABASH AVE
SPRINGFIELD, IL 62704-5352
Phone number: 217-528-7541
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Mailing Address
MARY T SAMULEVICH APRN
1025 S 6TH ST
SPRINGFIELD, IL 62703-2499
Phone number: 217-528-7541
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