Individual
JENNIFER A SIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2250 NORTH ILLINOIS AVE, CARBONDALE, IL 62901
(618) 833-1691
(618) 503-0688
Mailing address
2250 NORTH ILLINOIS AVE, CARBONDALE, IL 62901
(618) 833-1691
(618) 503-0688
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A54919
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A549190
BLUE SHIELD
CA
05
—
00A549190
—
CA
Enumeration date
05/24/2006
Last updated
06/22/2023
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