Healthcare Provider Details

I. General information

NPI: 1457994949
Provider Name (Legal Business Name): TORIA M PLOTNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 10/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 N CLARENDON CT
SAVOY IL
61874-6012
US

IV. Provider business mailing address

411 N CLARENDON CT STE 103
SAVOY IL
61874-6053
US

V. Phone/Fax

Practice location:
  • Phone: 217-522-1058
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: