Individual
DR. JOSEPH PATRICK COSTELLO III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4212 N ILLINOIS ST, SWANSEA, IL 62226-1835
(618) 233-6685
(618) 233-6616
Mailing address
PO BOX 217, O FALLON, IL 62269-0217
(618) 233-6685
(618) 233-6616
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036079559
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
371390565
FEDERAL TAX ID
IL
01
—
432064512
FEDERAL TAX ID
IL
05
—
O36079559
—
IL
Enumeration date
10/03/2006
Last updated
11/30/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us