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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 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 1851377717 NPPES
Illinois MEDICAID 036104541

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