Healthcare Provider Details

I. General information

NPI: 1184052516
Provider Name (Legal Business Name): DINA G SWANSON APRN-FPA, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DINA G GABRA ARPN-FPA, FNP-BC

II. Dates (important events)

Enumeration Date: 10/22/2013
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 N LOGAN AVE
DANVILLE IL
61832-4384
US

IV. Provider business mailing address

723 N LOGAN AVE
DANVILLE IL
61832-4384
US

V. Phone/Fax

Practice location:
  • Phone: 217-213-5808
  • Fax: 217-213-6290
Mailing address:
  • Phone: 217-213-5808
  • Fax: 217-213-6290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number277.000250
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209010779
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277.000250
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number277.000250
License Number StateIL
# 5
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number277.000250
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: