MA R DIFANIS

CHAMPAIGN, IL
NPI1851337109
Professional NameANGELA DIFANIS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209004432)
Enumeration Date2006-06-22
Last Update Date2013-11-21
Business Address
-- MA R DIFANIS NP
1701 CURTIS RD
CHAMPAIGN, IL 61822-9678
Phone number: 217-365-6203
Mailing Address
-- MA R DIFANIS NP
602 W UNIVERSITY AVE PROVIDER ENROLLMENT NCW4
URBANA, IL 61801-2530
Phone number: 217-383-6792
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