Maxwell, Dianne
Maxwell, Dianne is an individual health care provider with primary practice located at 1701 W Curtis Road Family Medicine/Convenient Care, Champaign IL 61822. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Maxwell, Dianne can be contacted via phone (217) 365-6203.Contact Information
Primary practice address
1701 W Curtis Road Family Medicine/Convenient Care
Champaign IL 61822
Phone: (217) 365-6203
Fax: (217) 326-4003
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 209001591 | Illinois |
Profile Details
| NPI number | 1841362225 |
|---|---|
| LBN Legal business name | Maxwell, Dianne |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 14th, 2006 |
| Last updated | Mar 10th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841362225 | NPPES |
| Illinois | Other | 0533210001 | DMERC |
| Illinois | Other | 500015565 | DMERC |
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