Odle, Phillip Ray

Odle, Phillip Ray is an individual health care provider with primary practice located at 3007 Edgewood Park , Marion IL 62959-5513. He recently has only one registered license in Nursing Service Providers / Registered Nurse, which is considered as his primary health care specialty. Odle, Phillip Ray can be contacted via phone (618) 889-0031.

Contact Information

Primary practice address
3007 Edgewood Park Marion IL 62959-5513
Phone: (618) 889-0031
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 041.401540 Illinois

Profile Details

NPI number 1417696568
LBN Legal business name Odle, Phillip Ray
Credentials MSN, RN-BC
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2022
Last updated May 27th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417696568 NPPES
Illinois Other 041.401540 REGISTERED NURSE LICENSE
Illinois Other 2011010604 REGISTERED NURSE LICENSE

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