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1467961706
SANDRA A FADER
BLOOMINGTON, IL
NPI
1467961706
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209016547)
Enumeration Date
2017-09-28
Last Update Date
2022-07-21
Business Address
Mrs. SANDRA A FADER APN
1111 TRINITY LN STE 111
BLOOMINGTON, IL 61704-8112
Phone number: 309-663-6461
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Mailing Address
Mrs. SANDRA A FADER APN
611 W. PARK ST FAPC
URBANA, IL 61801
Phone number:
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