Andrilyn Nededog, NP
Nurse Practitioner, Gerontology in Lake Villa, IL. Individual provider (NPI-1).
NPI number1952811366
StatusActive
Last updated in NPPESOct 17, 2017
Details
- NPI
- 1952811366
- Entity type
- Individual (NPI-1)
- Name
- Andrilyn Nededog
- Credential
- NP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 11, 2017
- Last updated
- Oct 17, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LG0600X | Nurse Practitioner, Gerontology | 209.016674 | IL | Yes |
| 363LA2200X | Nurse Practitioner, Adult Health | 209.016674 | IL |
Practice location
308 Appleton LnLake Villa, IL 60046-6405
Phone 224-330-7751
Mailing address
308 Appleton LnLake Villa, IL 60046-6405
Phone 224-330-7751
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