Moore-Connelley, Marci I
Moore-Connelley, Marci I is an individual health care provider with primary practice located at 405 W Jackson St , Carbondale IL 62901-1462. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Moore-Connelley, Marci I can be contacted via phone (618) 457-5200.Contact Information
Primary practice address
405 W Jackson St
Carbondale IL 62901-1462
Phone: (618) 457-5200
Fax: (618) 351-4820
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 036104541 | Illinois |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036-104541 | Illinois |
Profile Details
| NPI number | 1851377717 |
|---|---|
| LBN Legal business name | Moore-Connelley, Marci I |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 21st, 2005 |
| Last updated | Dec 8th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851377717 | NPPES |
| Illinois | MEDICAID | 036104541 |
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