Individual
DEIRDRE HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1414 CROSS ST STE 330, SHILOH, IL 62269
(618) 277-7400
Mailing address
1414 CROSS ST STE 330, SHILOH, IL 62269-2988
(618) 277-7400
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2011018402
MO
208600000X
Surgery Physician
ME 127352
FL
208C00000X
Colon & Rectal Surgery Physician
Primary
036.145842
IL
390200000X
Student in an Organized Health Care Education/Training Program
77655
GA
390200000X
Student in an Organized Health Care Education/Training Program
ME127352
FL
Other
Enumeration date
04/06/2011
Last updated
07/21/2022
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