MALLORY IVERSON

WAUCONDA, IL
NPI1366818692
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209013043)
Enumeration Date2015-08-20
Last Update Date2015-08-20
Business Address
-- MALLORY IVERSON APN
431 W LIBERTY ST
WAUCONDA, IL 60084-2452
Phone number: 847-526-2151
Mailing Address
-- MALLORY IVERSON APN
PO BOX 6037
WAUCONDA, IL 60084-6037
Phone number: 847-526-2151
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