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Paula R Icenogle
Driver in Colchester, Illinois
NPI 1023281847

Paula R Icenogle is a Driver based in Colchester, IL. Paula R Icenogle practices in Colchester, IL. The NPI Number for Paula R Icenogle is 1023281847 and holds a License No. I25267678827 (Illinois).

The current practice location address for Paula R Icenogle is 708 Sherry St, Colchester, IL and can be reached out via phone at 309-776-3978.

Location: 708 Sherry St, Colchester, IL, 62326-1176
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023281847
Provider Name
Paula R Icenogle
Credential
Provider Entity Type
Individual
Gender
Female
Address
708 Sherry St, Colchester, IL, 62326-1176
Phone Number
309-776-3978
Fax Number
Provider Enumeration Date
04/13/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
708 Sherry St
City
Colchester
State
Illinois
Zip
62326-1176
Phone Number
309-776-3978
Fax Number
person
Provider Business Mailing Address Details
Address
708 Sherry St
City
Colchester
State
Illinois
Zip
62326-1176
Phone Number
309-776-3978
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
172A00000X
License No.
I25267678827 (Illinois)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
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