Provider Demographics
NPI:1720689045
Name:DINGES, NANCY LEE
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LEE
Last Name:DINGES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 MONARCH DR
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62629-9638
Mailing Address - Country:US
Mailing Address - Phone:309-335-2473
Mailing Address - Fax:
Practice Address - Street 1:3401 FREEDOM DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-6517
Practice Address - Country:US
Practice Address - Phone:217-793-3368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.35353183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist