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1114196904
SUMMER L PARK
CHAMPAIGN, IL
NPI
1114196904
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Former Name
SUMMER L ROESCHLEY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209006933)
Enumeration Date
2008-02-26
Last Update Date
2014-11-05
Business Address
-- SUMMER L PARK APN
1801 WINDSOR RD
CHAMPAIGN, IL 61822-6217
Phone number: 217-366-6104
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Mailing Address
-- SUMMER L PARK APN
101 W UNIVERSITY AVE
CHAMPAIGN, IL 61820-3909
Phone number: 217-366-1326
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