Individual
DR. CARA E VASCONCELLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3132 OLD JACKSONVILLE RD, SUITE 200, SPRINGFIELD, IL 62704-7400
(217) 862-0804
(217) 862-0871
Mailing address
3132 OLD JACKSONVILLE RD, SUITE 200, SPRINGFIELD, IL 62704-7400
(217) 862-0804
(217) 862-0871
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036087654
IL
208000000X
Pediatrics Physician
Primary
036087654
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087654
—
IL
Enumeration date
02/20/2006
Last updated
03/01/2012
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