MARY TISDALE

PEORIA, IL
NPI1992034532
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367A00000X Advanced Practice Midwife
(Licence: IL  209007925)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: IL  209008217)
367A00000X Advanced Practice Midwife
(Licence: FL  APRN11000699)
Enumeration Date2009-12-10
Last Update Date2021-04-05
Business Address
MARY TISDALE CNM
1001 MAIN ST STE 300
PEORIA, IL 61606-2036
Phone number: 309-495-0200
Mailing Address
MARY TISDALE CNM
1025 S 6TH ST
SPRINGFIELD, IL 62703-2403
Phone number: 217-528-7541