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1760887152
RUSSIA VEGA
DANVILLE, IL
NPI
1760887152
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209011985)
Enumeration Date
2014-10-28
Last Update Date
2014-11-26
Business Address
-- RUSSIA VEGA NP
311 W. FAIRCHILD ST.
DANVILLE, IL 61832-3803
Phone number: 217-431-7600
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Mailing Address
-- RUSSIA VEGA NP
611 W. PARK ST. BWPC
URBANA, IL 61801-2500
Phone number: 217-383-6792
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