Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 209.014512 | IL |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 209014512 | IL |
NPI | 1073965570 |
---|---|
Provider Name | Hillary Danenberger |
First Address | Springfield, IL 62702-5131 |
Second Address | Urbana, IL 61801-2529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2016 |
Last Update Date | 30/09/2021 |