Connolly, Michael

Connolly, Michael is an individual health care provider with primary practice located at 1001 Illini Dr , East Peoria IL 61611-1883. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Connolly, Michael can be contacted via phone (309) 694-2620.

Contact Information

Primary practice address
1001 Illini Dr East Peoria IL 61611-1883
Phone: (309) 694-2620
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019-025916 Illinois

Profile Details

NPI number 1487921490
LBN Legal business name Connolly, Michael
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2011
Last updated Nov 18th, 2011 - about 14 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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