Individual
MOLLY LUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2005 JACOBSSEN DR, NORMAL, IL 61761-6287
(309) 319-7360
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036132003
IL
208000000X
Pediatrics Physician
125.058507
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1189264
AAP ID
IL
01
—
125.058507
TEMPORARY MEDICAL LICENSE
IL
Enumeration date
06/15/2010
Last updated
02/03/2023
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