Individual
PHILIP D KANNEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2 SAINT ANTHONYS WAY, SUITE 305, ALTON, IL 62002-4569
(618) 462-2277
(618) 463-9342
Mailing address
2 SAINT ANTHONYS WAY, SUITE 305, ALTON, IL 62002-4569
(618) 462-2277
(618) 463-9342
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036067336
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067336
—
IL
Enumeration date
05/05/2006
Last updated
01/22/2014
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