Dr Kelly M Farroll, MD | |
2166 Madison Ave, Granite City, IL 62040-4700 | |
(618) 452-3301 | |
(618) 452-3312 |
Full Name | Dr Kelly M Farroll |
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Gender | Female |
Speciality | Family Medicine |
Location | 2166 Madison Ave, Granite City, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063503704 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 036-093514 (Illinois) | Secondary |
207Q00000X | Family Medicine | 036093514 (Illinois) | Primary |
Entity Name | Southern Illinois Healthcare Foundation, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013198712 PECOS PAC ID: 1456256874 Enrollment ID: O20031126000641 |
Mailing Address | Practice Location Address |
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Dr Kelly M Farroll, MD 2166 Madison Ave, Granite City, IL 62040-4700 Ph: (618) 452-3301 | Dr Kelly M Farroll, MD 2166 Madison Ave, Granite City, IL 62040-4700 Ph: (618) 452-3301 |
Dr. David L Priebe, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3986 Maryville Rd, Granite City, IL 62040 Phone: 618-797-0618 Fax: 618-797-2243 | |
Crisale Cosas, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2100 Madison Ave, Granite City, IL 62040 Phone: 618-798-3000 | |
Kevin L Bell, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 2407 Corporate Ctr Ste C, Granite City, IL 62040 Phone: 618-779-6782 |