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Individual
EDWARD A CONNOLLY
Active
Individual
EDWARD A CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036093095
IL
207X00000X
Orthopaedic Surgery Physician
28464
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028389
HEALTH ALLIANCE
—
05
—
036093095
—
IL
01
—
05353
WELLMARK
—
01
—
18604
MIDLANDS CHOICE
—
05
—
1917237
—
IA
01
—
200029113
RR MEDICARE
—
01
—
20170
IA HEALTH SOLUTIONS
—
01
—
8121085
BCBS
IL
01
—
99717
WELLMARK
—
01
—
99728
WELLMARK
—
01
—
IA0194
JOHN DEERE FAMILY
—
01
—
IL0174
JOHN DEERE FAMILY
—
Enumeration date
01/04/2006
Last updated
03/18/2011
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